From the Guidelines
For verbo palsy, which I assume refers to verbal apraxia or speech disorders, we typically order a comprehensive speech and language evaluation by a speech-language pathologist (SLP) as the first line of treatment. This evaluation should assess speech production, language comprehension, and oral motor function. The goal of this evaluation is to identify the specific areas of difficulty and develop a personalized treatment plan 1.
Following evaluation, speech therapy is the primary treatment, typically scheduled 2-3 times weekly for several months, with home practice exercises between sessions. Speech therapy may involve various strategies, including education and explanatory approaches, symptomatic treatments, and psychological interventions 1. For example, symptomatic treatments may include reduction of excessive musculoskeletal tension in speech and non-speech muscles, elimination of secondary or accessory movements, and focusing on normal movements and sounds 1.
In some cases, augmentative and alternative communication (AAC) devices may be recommended to supplement verbal communication while speech skills develop. No medications are specifically indicated for verbal apraxia itself, though if the condition stems from a stroke or neurological injury, the underlying condition may require medical management 1. Speech therapy works by retraining neural pathways involved in speech planning and production through repetitive practice and specialized techniques.
Some key considerations in the treatment of verbo palsy include:
- Early intervention, ideally starting before age 3 for children with developmental verbal apraxia
- A comprehensive treatment plan that addresses speech production, language comprehension, and oral motor function
- The use of AAC devices to supplement verbal communication
- Collaboration with other healthcare professionals, such as physiotherapists or occupational therapists, to address related symptoms or conditions 1.
Overall, the primary goal of treatment for verbo palsy is to improve speech and communication skills, and to enhance overall quality of life 1.
From the Research
Treatment for Bell's Palsy
The treatment for Bell's palsy typically involves a combination of medications to manage symptoms and promote recovery.
- The primary treatment options include:
- Antiviral medications, such as valacyclovir
- Corticosteroids, such as prednisone
- Studies have shown that the combination of valacyclovir and prednisone is more effective than no medical treatment or prednisone alone in treating Bell's palsy 2, 3.
- A systematic review and network meta-analysis found that corticosteroids plus antivirals were the most effective treatment for Bell's palsy, with a higher rate of complete recovery and lower rate of synkinesis compared to placebo 4.
Medication Dosage
The dosage of valacyclovir and prednisone may vary depending on the study or treatment protocol.
- One study used a dosage of 1 g of valacyclovir hydrochloride 3 times per day for 7 days and 50 mg of prednisone daily for 5 days, with the dose being reduced by 10 mg daily for the next 5 days 2.
- Another study used a dosage of 1,000 mg of valacyclovir per day for 5 days and prednisolone administered orally 3.
Efficacy of Treatment
The efficacy of treatment for Bell's palsy can vary depending on the severity of the condition and the timing of treatment.
- Studies have shown that early treatment with valacyclovir and prednisone can improve outcomes and reduce the risk of severe sequelae 2, 3.
- The overall rate of patient recovery among those treated with valacyclovir and prednisone was significantly better than the rate among those treated with prednisone alone or placebo 3, 4.