Idiopatic facial nerve palsy in pregnancy – facts and myths

Abstract

Idiopathic facial nerve palsy, called also Bell palsy, can be a challenge for clinicians if a pregnant woman reports symptoms of facial paresis. The incidence of Bell's paralysis in pregnant women is almost three times higher than in the non-pregnant women's age group. The problem is the lack of guidelines for the treatment of idiopatic facial nerve palsy in this group of patients. In randomized studies, but without participation of pregnant women, greater efficacy was found in the return of nerve function after early treatment with corticosteroids than with other methods. The dilemma concerning therapy is intensified by the fact that the prognosis regarding the return of facial nerve function in pregnant women is significantly worse than in the remaining population and the weakness of facial muscles is yet diagnosed in a young woman. In the article we present the example of a patient consulted in our department and the review of current literature. We introduce recommendations for the treatment of pregnant women with facial nerve palsy. There are discussed benefits, advised medicines, doses, necessary precautions and potential side effects of corticosteroids, which are the only ones that have proven efficacy in the treatment of Bell's paralysis in pregnant women.