Bell's Palsy in Pregnancy: Causes, Symptoms and Treatment

How to Deal With Bell’s Palsy During Pregnancy

Medically Reviewed By
Dr. Rima Sonpal (Gynecologist/Obstetrician)
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Pregnancy is a tough but rewarding time- all the more so when you are holding your bundle of joy in your arms. However, there is also an increased likelihood of developing a facial paralysis condition late in the third trimester or just after giving birth. Although facial paralysis during pregnancy can sometimes be associated with a stroke, in a few cases it can be worse. This condition is known as Bell’s Palsy, and it can be quite terrifying, especially during this vulnerable period.

What is Bell’s Palsy?

Bell’s palsy occurs due to the inflammation of the inner ear, which then exerts pressure on the facial nerve when it expands. This causes one side of the face to droop, and can also affect saliva and tear production. Bell’s palsy is most likely in people who are either under forty or over sixty years old. Around ten to forty people per lakh are affected by it. However, when considering pregnant women, around 0.05 percent are affected, when compared with 0.02 percent for non-pregnant women of similar age.

What Are the Causes of Bell’s Palsy During Pregnancy?

What Are the Causes of Bell's Palsy During Pregnancy?

Bell’s Palsy is known as an idiopathic syndrome, which means that its causes are quite unclear. Nevertheless, some connections have been established.

  • Research has shown that the occurrence of Bell’s palsy coincides with the activation of herpes simplex viruses in the temporal bone behind the ear. The virus then causes the inflammation of the facial nerve, leading to paralysis.
  • Finally, a pregnancy complication known as HELLP syndrome, or Haemolysis, elevated liver enzymes and low platelet count, have been linked with Bell’s palsy.
  • Bell’s palsy has been shown to be more likely in people who have respiratory infections like common cold or influenza.

Why Are Pregnant Women at Higher Risk of Getting Bell’s Palsy?

How common is Bell’s palsy during pregnancy? There are several theories regarding the raised risk of Bell’s palsy in pregnant women. Some of them include.

  • Disorders of the blood, such as certain problems with clotting, occur during pregnancy.
  • Increase in blood pressure
  • Eclampsia and preeclampsia are pregnancy conditions that can lead to Bell’s palsy by causing swelling around the facial nerve.
  • Pregnancy fluid retention, that is an increase in the body fluid, can occur around the facial nerve, putting pressure on it.
  • Fluctuations in the pregnancy hormones, progesterone and oestrogen.
  • Lowered tolerance to glucose, such as gestational diabetes, can damage the facial nerve, causing paralysis.
  • Increase in the levels of the stress hormone cortisol after the second trimester.

Signs and Symptoms of Bell’s Palsy

Bell’s palsy appears with a host of symptoms within a few hours. They include:

  • Trouble moving part of the mouth, such as smiling or pouting.
  • Eyelids and mouth corners drooping.
  • Weakness or twitching on the side of the face.
  • Eyes and mouth experiencing dryness.
  • Difficulty speaking or tasting food.
  • Discomfort or aching in the jaw region or near the ears.
  • A loud ringing sound in either or both ears
  • Oversensitivity to most loud sounds.
  • Headaches, dizziness and drooling.
  • Unable to lift the eyebrow or blink properly.
  • Overproduction of tears as a response to the dryness.

How is Bell’s Palsy Diagnosed?

There are a series of comprehensive tests which can analyse the symptoms of Bell’s palsy and make an accurate diagnosis.

  • Test for hearing to ensure you can hear everything clearly, including checking for ringing sounds or tinnitus.
  • Vestibular test to check for inner ear imbalance and explain dizziness symptoms.
  • Testing to see the level of fluid production from the tear ducts.
  • Electromyography or EMG is a measurement of muscular activity and can test for the presence and extent of nerve damage.
  • Evaluation of the nose and throat to check for problems with eating and drinking.
  • MRI scanning of the brain and the inner auditory canals of the ears.
  • Checking for rashes around the ears or scalp to rule out the possibility of Ramsay Hunt syndrome.

How is Bell's Palsy Diagnosed?

How Bell’s Palsy is Treated in Pregnancy

There are no strict medical procedures to deal with the monitoring and treatment of a pregnant woman with Bell’s palsy. Nevertheless, evidence suggests a few treatment methods that help in managing Bell’s palsy during pregnancy.

  • Use of corticosteroids like prednisolone has shown to reduce the facial paralysis from progress as well as stimulate the recovery of muscular movement. This mode of treatment is best used within three days of experiencing symptoms. However, often these medications are associated with various pregnancy complications and are, therefore, delayed until after birth.
  • In extreme cases of facial paralysis, antiviral drugs like valacyclovir are prescribed in combination with corticosteroids. However, while antivirals might be beneficial, its efficacy is still relatively unknown.
  • Alternative treatment methods include acupuncture and face massages. These techniques have had limited success in reducing pain symptoms and promoting recovery of nerve function over a course of several months.
  • Physical therapy is also employed to prevent paralysed muscles from shrinking and tightening.
  • You can also use over-the-counter pain medications such as ibuprofen and paracetamol to help with the symptoms.
  • It helps to keep both your eyes well-lubricated with eyedrops in case the paralysis prevents them from closing properly.
  • Most cases of Bell’s palsy are mild enough to not need any treatment, as the condition resolves by itself within two weeks to a month.

What Are the Recovery Rates of Bell’s Palsy in Pregnancy?

The prognosis for Bell’s palsy recovery rates in pregnant women is unfortunately not as high as the general populace. For instance, while over eighty percent of non-pregnant Bell’s palsy patients recovered within ten days after the symptoms appeared, only about fifty percent of pregnant women recovered.

Physical and Psychological Effects of Bell’s Palsy on Pregnant Women

Physical and Psychological Effects of Bell's Palsy on Pregnant Women

The Physical Effects of Bell’s Palsy on Pregnant Women Include:

  • Trouble with blinking or closing the eyes fully. Pregnant patients tend to have dry eyes because of hormone fluctuations. In addition to dryness, you might experience eye infections, blurry vision, redness, burning, grittiness, and so on.
  • Inability to eat and drink properly due to paralysis of facial muscles. This prevents holding items in the mouth without spillage.
  • Similarly, difficulty speaking with clarity is a common symptom due to the lack of control over the jaw muscles.

Psychological Effects of Bell’s Palsy on Pregnant Women Include:

  • Bell’s palsy might make it difficult to express emotions, such as smiling and laughing. This can become a problematic issue as you have a baby now to love and take care of.
  • You might feel vulnerable, depressed, anxious and unable to help yourself. At this stage, it is important that you seek support from your partner, family and other loved ones.
  • Women affected by Bell’s palsy can be sensitive about their facial appearance as the paralysis causes the facial muscles to sag.

Can Bell’s Palsy Be Prevented?

How to prevent Bell’s palsy in pregnancy? There is no recorded information which can help one in preventing Bell’s palsy. However, if your baby acquires the condition due to doctors negligence during delivery, you have the right to file a legal suit for physical as well as emotional damage, However, this should be proven, as most of the times consent will be taken explaining the risks of birth trauma beforehand and most of the times, this condition isn’t under anyone’s control

Bell’s palsy is usually a temporary condition and disappears within a short time. You can ensure that you stay comfortable by following a few simple steps. Drink lots of water, keep a humid environment, and most importantly, communicate with your loved ones. They are only here to help.

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