Bell's palsy in pregnancy and the puerperium

The incidence of Bell's palsy is significantly higher during the last trimester of pregnancy and the puerperium. Suggested explanations for this association include fluid retention, hypertension, compromise of the vasa nervorum, infection (particularly with herpes simplex virus), and an autoimmune process. The diagnosis is confirmed by identifying lower motor neurone paralysis and excluding secondary causes for the symptom complex. The majority of cases resolve spontaneously. Recovery may be delayed or incomplete in older patients and those with recurrent episodes or severe initial symptoms. The role of diuretics, steroids, or surgical decompression in treatment of pregnancy-related cases of Bell's palsy has not been well studied.