The Bell's palsy is the most common disorder of the facial nerve during pregnancy. It is characterised with the onset of unilateral weakness and paralysis of the facial muscles. The etiology is unknown. The incidence during pregnancy and early postpartum period is three times of the non-pregnant women, 38-45 cases on 100 000 births. The risk is uneven during pregnancy, highest in the third trimester and the postpartum period. There were 2 Bell's palsy cases in our department within a couple of months. Both of them recovered completely in spite of the different treatment strategies. We discuss these cases and the treatment options. Recovery is usually satisfactory. In 85% of Bell's palsy, the function of the nervous facial recovers completely. Though supportive therapy is recommended. The beneficial effect of steroid and/or antiviral therapy is not proved. During pregnancy steroid and antiviral treatment of Bell's palsy is controversial. Supportive therapy is the mainstay of management in pregnancy. Steroids may relieve the facial and periauricular pain, but they have no effect on hastening recovery. A possible association of Bell's palsy with hypertensive disease of pregnancy may preclude further the use of steroids. Prednisolone apparently poses a very small risk to the developing foetus. Considering the high endogen steroid production and levels during the third trimester, the exogenous corticosteroid supplementation during pregnancy is even more questionable. The review of the literature showed that the majority of pregnant patients with Bell's palsy were treated with prednisolone, although the benefit of this practice has not yet been proven. Relative contraindications, such as hypertensive disease and infectious neonatal morbidity, late psychosomatic abnormalities should be taken into consideration. The use of an antiviral drug, acyclovir is even more questionable during pregnancy.
|Number of pages||6|
|Journal||Magyar Noorvosok Lapja|
|Publication status||Published - Dec 1 2004|
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology