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. [1-2]
The good news is that Ball’s palsy is rare, even in pregnancy, 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 know about it. [1-2]
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. [1-3]
Symptoms of weakness or paralysis start suddenly and may get worse over about one to two days. Because 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: [1-3]
- Inability to smile or blow out your cheek
- Inability to squint or close your eye
- Sensitivity to loud sounds
- Loss of taste
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. [1-3]
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. [1,2]
Theories of why Bell’s palsy occurs in pregnancy include: [1,2]
- 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. [2-3]
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 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. [2-3]
One more treatment that is always recommended is protecting your eye. Because you may have trouble closing it, the eye can become damaged from dryness. You doctor may have you tape the eye shut at night and have you put in moisturizing drops during the day. [2-3]
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. [2-3]