Title : Recovery from refractory bell’s palsy via photobiomodulation laser therapy
Abstract:
Bell’s palsy is an acute, idiopathic paralysis of the facial nerve, frequently linked to viral reactivation. Most patients recover within 6 weeks to 3 months, but up to 30 percent experience persistent facial weakness, asymmetry, or synkinesis. Moreover, this disorder is frequently accompanied by a significant psychosocial impact leading to depression, social withdrawal, and an overall diminished quality of life. Current clinical guidelines recommend oral corticosteroids as first-line therapy, with or without antivirals. However, in cases of delayed recovery, there is a clear need for employing alternative therapies in order to improve patient outcomes. Adjunctive modalities such as photobiomodulation therapy (PBMT) and physiotherapy have shown promise in facilitating nerve regeneration and functional recovery.
We present a case of a 70-year-old man who was referred to our clinic with four months of refractory hemifacial paralysis, subsequent to varicella-zoster virus infection. Prior to arrival, he was treated with combined systemic corticosteroids and antivirals. Clinical examination demonstrated marked facial asymmetry, lagophthalmos, and complete hemifacial paralysis. The patient underwent a personalized treatment protocol, which combined three sessions of PBMT using a 940 nm diode laser combined with head and neck physiotherapy over a ten-day period. This treatment approach resulted in remarkable functional improvement and recovery within a relatively short time.
This case highlights the potential use of PBMT as an adjuvant therapy in Bell’s palsy, particularly in refractory cases, when promoting neuro-muscular recovery. The significant functional improvement observed within 10 days of laser treatment, occurring four months of symptom onset and beyond the typical spontaneous recovery window, suggest a possible therapeutic effect of PBMT.
