Electric Stimulation Therapy for Bell’s Palsy in the Acute Stage: A Systematic Review and Meta-Analysis

Abstract

Introduction:

Bell’s palsy, an idiopathic peripheral facial palsy, often resolves naturally but can benefit from electric stimulation therapy. However, efficacy and safety during the acute stage remain controversial and understudied.

Objective:

To measure the effectiveness of electrical stimulation therapy as an add-on treatment for patients in the acute stage of Bell’s palsy, as measured by incomplete recovery rates.

Methods:

We searched nine databases for randomized controlled trials comparing add-on electric stimulation therapy with usual care or placebo in patients within 7 days of Bell’s palsy onset. The primary outcome was incomplete recovery. Risk of bias was assessed using Cochrane RoB 2 tool, with results synthesized via random-effects meta-analysis and evidence certainty evaluated using GRADE.

Results:

Fourteen studies encompassing 1,311 participants were included. Electric stimulation therapy plus usual care reduced incomplete recovery rates compared with usual care alone (risk ratio 0.65, 95% CI: 0.48–0.88; 13 trials, n = 1,191; moderate certainty). The effect persisted after excluding six studies with a high risk of bias.

Conclusion:

Add-on electric stimulation therapy during acute Bell’s palsy may reduce incomplete recovery risk. However, results had moderate certainty with limitations including risk of bias and short follow-up durations.