Simultaneous bilateral facial palsy in pregnancy

The risk of facial palsy for pregnant women is higher than for nonpregnant women. Most cases occur in the third trimester and the immediate postpartum period. Unilateral facial palsy is a commonly seen mononeuropathy. Bilateral facial palsy, however, is rare and is most often a sign of a systemic disease. The authors present the case of a pregnant woman who was first seen with left-sided facial paralysis. The paralysis then spread to the right side, resolved quickly after delivery, but appeared again on the right side 6 months later. The authors warn that bilateral facial palsy seen in pregnancy may be a sign of serious underlying disease. Differential diagnosis, possible etiologies, treatment, and prognosis are discussed.