Bell’s Palsy in Pregnancy

Bells Palsy Pregnancy

The last thing you need late in your pregnancy is to look in the mirror and see a drooping face looking back at you. Bell’s palsy is the most common cause of facial paralysis, and it is more common in pregnancy. It usually occurs suddenly on one side of your face.

The good news is that Bell’s palsy is rare, even in pregnancy, at about 1 case in 50,000 pregnancies. It usually goes away within a few weeks or months. It should not affect your pregnancy or your baby. However, it is scary and a risk for pregnant women so you should be informed.

What Is Bell’s Palsy?

Bell’s palsy was first described by the Scottish physician, Charles Bell, in 1830. It is a weakness or paralysis of the facial nerve. The facial nerve is also called the seventh cranial nerve. It passes from your brain to the muscles of your face through a bony canal near your ear. If the nerve swells inside the canal, it becomes compressed, and nerve signals are slowed or stopped.

Symptoms of weakness or paralysis start suddenly and may get worse over about one to two days. Since the facial muscles are called the muscles of expression, one side of your face may have a blank look. The normal wrinkles on one side of your forehead and around your nose and eyes may disappear. Other signs and symptoms include the following:

  • Inability to smile or blow out your cheek
  • Inability to squint or close your eye
  • Numbness
  • Headache
  • Sensitivity to loud sounds
  • Loss of taste
  • Drooling
  • Tearing

Women who have high blood pressure late in pregnancy–preeclampsia–are four to five times more likely to have Bell’s palsy.

Why Does Bell’s Palsy Happen During Pregnancy?

The exact cause of Bell’s palsy is mysterious. One of the mysteries is why it only occurs on one side. There are many possible causes. They include a herpes virus infection that attacks the nerve, an immune system reaction that causes swelling of the nerve, and decreased blood supply to the nerve. Pregnancy may make you susceptible to these causes.

Bell’s palsy in pregnancy almost always occurs during the third trimester or shortly after giving birth. Women who have high blood pressure late in pregnancy–preeclampsia–are four to five times more likely to have Bell’s palsy. Gaining too much weight and retaining lots of fluid during pregnancy are other risks.

Theories of why Bell’s palsy occurs in pregnancy include the following:

  • Changes in your immune system which make you more susceptible to viral infection
  • Hormones of pregnancy (estrogen, progesterone, and cortisol) which may cause swelling of the nerve
  • Higher tendency for blood clotting which may cause tiny vessels that supply the nerve to close down
  • High blood pressure and fluid retention which may cause nerve swelling

Can Bell’s Palsy Be Treated?

Your doctor can diagnose Bell’s palsy without any lab tests by its sudden onset and the signs and symptoms. There is no cure for Bell’s palsy, but there are treatments that may slow down the course of the condition and help speed recovery.

Steroids given early after the onset of Bell’s palsy can help. If you have a rash on one side of your face or blisters in your mouth, the cause may be the herpes virus. In this case, a course of antiviral medication may be started as soon as possible. Both steroids and antiviral medications can be used late in pregnancy.

One more treatment that is always recommended is protecting your eyes. Since you may have trouble closing them, the eyes can become damaged from dryness. You doctor may have you tape the eyes shut at night and have you put in moisturizing drops during the day.

Bell’s palsy usually starts to improve in a few weeks and almost always gets better within 6 months. It is more scary than dangerous. It is important to let your doctor know about any signs or symptoms of Bell’s palsy right away. If treatment is needed, it works best when started as soon as possible.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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