Background: Bell’s palsy is the most common cause of acute unilateral facial paralysis. Corticosteroids are the established first-line treatment, while the role of antivirals remain controversial. Given the limited bioavailability of oral acyclovir, intravenous administration may offer superior outcomes. Objective: To compare the efficacy of intravenous versus oral acyclovir, both in combination with corticosteroids, in patients with Bell’s palsy. Methods: A prospective, comparative study was conducted over 12 months in a tertiary care teaching hospital. Sixty patients with acute-onset idiopathic facial palsy (≤72 hours) were enrolled and randomized into two groups: Group A (oral acyclovir 400 mg five times daily with prednisolone) and Group B (intravenous acyclovir 10 mg/kg every 8 hours with prednisolone). Outcomes were assessed using the House–Brackmann (HB) grading system and nerve conduction studies (NCV) at baseline, 1 month, and 3 months. The primary endpoint was the proportion of patients achieving HB Grade I–II at 3 months.

Bell’s palsy, facial nerve paralysis, acyclovir, corticosteroids, intravenous therapy