A patient with Bell's palsy (confirmed LMN lesion, unable to close eye) presents within 72 hours of onset. What is the MOST important medication to prescribe?

Correct answer: A. Antiviral medication (e.g., acyclovir or valacyclovir)

• A. CORRECT. Per current evidence (AAO-HNS guidelines), if Bell's palsy is treated within 72 hours of onset, the PRIMARY medication is oral corticosteroids (prednisone). Antivirals (valacyclovir) are often added given the presumed HSV-1 reactivation etiology, though evidence for antivirals alone is weaker. Combined therapy (steroid + antiviral) within 72h of onset has the best outcomes for complete recovery. The question asks for the MOST important: antiviral + corticosteroid = best current practice.
• B. Antibiotics are not indicated for Bell's palsy — it is a viral/idiopathic condition, not bacterial.
• C. COMBINED antiviral + corticosteroids is the best evidence-based treatment when initiated within 72 hours — this is the most appropriate answer.
• D. Corticosteroids alone (without antiviral) are the minimum evidence-based treatment. Most guidelines recommend combined therapy for optimal outcomes.