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Bell's Palsy in Pregnancy.

Victor Evangelista1, Megan S Gooding2, Leonardo Pereira3

  • 1Neurology Resident, Department of Neurology, Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil.

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Bell's palsy is more common and severe in pregnant individuals, often leading to worse outcomes. Early steroid treatment is recommended for Bell's palsy during pregnancy, though risks exist.

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Area of Science:

  • Neurology
  • Obstetrics
  • Facial Nerve Disorders

Background:

  • Bell's palsy incidence and severity increase during pregnancy, particularly in the third trimester and postpartum.
  • Pregnancy-associated Bell's palsy may result in poorer long-term facial nerve recovery compared to non-pregnant individuals.

Purpose of the Study:

  • To review the diagnosis, treatment, and prognosis of Bell's palsy in pregnant patients.
  • To provide a clinical reference for healthcare providers managing Bell's palsy during pregnancy.

Main Methods:

  • A literature review of neuropathies in pregnancy, Bell's palsy clinical presentation, and treatment protocols.
  • Searches were conducted using MEDLINE and PubMed, with referenced articles serving as primary sources.

Main Results:

  • Diagnosis involves clinical tests like Wartenberg's lid vibration and eyelash occlusion tests, and assessing facial asymmetry.
  • Corticosteroids for 10 days are recommended; antiviral therapy has less evidence. Delayed treatment and pregnancy are linked to persistent palsy.
  • Early treatment (within 3 days) generally leads to full recovery. Recurrence of Bell's palsy during pregnancy is uncommon.

Conclusions:

  • Limited literature exists on diagnosing and treating Bell's palsy in pregnant women.
  • Bell's palsy prognosis during pregnancy is less favorable than in the general population.
  • Early corticosteroid intervention is advised, acknowledging potential risks.