Did you know that pregnant women are at a higher risk of developing Bell’s palsy? Pregnancy itself can present enough challenges, so if you experience Bell’s palsy during pregnancy or after birth, we want to make sure you are fully educated on what is going on.
Bell’s palsy is one of the primary causes of facial paralysis in the United States. Studies show Bell’s palsy occurs when herpes simplex virus (HSV) is reactivated in the temporal bone, i.e. the bone behind the ear. This causes the facial nerve to swell, resulting in paralysis or weakness on one side of the face.
Bell’s palsy during pregnancy begins suddenly and reaches its peak within about 48 hours. Common Bell’s palsy symptoms include:
- Difficulty eating or drinking
- Discomfort or pain around the jaw and behind the ear
- Drooping of the eyelid and corner of the mouth
- Eye or mouth dryness
- Impairment of speech or taste
- Ringing in one or both ears
Research indicates most Bell’s palsy cases in pregnant women take place during the third trimester or early post-partum period. Bell’s palsy may be the result of preeclampsia. Additionally, Bell’s palsy has been linked to haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome.
Preeclampsia is a disorder that causes high blood pressure in pregnant women. It affects about 5% of pregnant women in the United States and develops after week 20 of pregnancy. There usually are no visible symptoms associated with preeclampsia. If preeclampsia goes unaddressed, it may put a pregnant woman and her baby in danger.
Severe preeclampsia causes reduced blood flow to the brain, kidneys and other vital organs. When this occurs, blood vessels leak fluid into tissues, resulting in edema (swelling). Also, if tiny blood vessels in the kidneys leak, protein from the bloodstream seeps into the urine. This puts a baby at risk and may result in poor growth, a deficient amount of amniotic fluid or placental abruption (when the placenta breaks away from the uterine wall prior to delivery).
During a prenatal checkup, a healthcare provider will examine a pregnant woman’s blood pressure and urine levels and may request blood tests to diagnose preeclampsia. Other tests may be performed to provide an accurate preeclampsia diagnosis, including tests of the kidney and blood-clotting functions, an ultrasound scan to evaluate a baby’s growth and a Doppler scan to evaluate the efficiency of blood flow to the placenta.
Mild preeclampsia in pregnant women may be treated in a number of ways. A doctor may recommend additional rest, reduced salt consumption, increased water intake or dietary changes. Or, in cases of severe preeclampsia, a doctor may prescribe blood pressure medication.
HELLP often is considered a variant of preeclampsia. The syndrome generally develops during the third trimester of pregnancy and affects pregnant women within 48 hours of delivery. It affects less than 1% of pregnant women, and between 4% and 12% of pregnant women diagnosed with preeclampsia develop HELLP.
The symptoms of HELLP include abdominal pain, fatigue, headaches, nausea and vomiting. Because these symptoms are commonly associated with many conditions and complications, HELLP can be difficult to diagnose. Oftentimes, doctors will use blood pressure measurements and urine tests to monitor protein levels to properly diagnose HELLP.
Even pregnant women who do not have preeclampsia or HELLP may experience Bell’s palsy. In fact, pregnant women may be predisposed to Bell’s palsy due in part to their high extracellular fluid content, viral inflammation or the immunosuppression characteristic of pregnancy itself.
There is no surefire solution to treat Bell’s palsy during pregnancy. Bell’s palsy treatment varies based on time and presentation, and a pregnant woman who develops Bell’s palsy should consult with her OB/GYN.
In approximately 85% of Bell’s palsy cases, the facial paralysis symptoms disappear on their own, and a patient regains full facial movements. If Bell’s palsy symptoms linger for eight months or longer, it may be time to schedule a consultation with Dr. Babak Azizzadeh of The Facial Paralysis Institute.
Dr. Azizzadeh is a world-renowned facial plastic and reconstructive surgeon with comprehensive facial nerve expertise. He recommends a series of tests to analyze Bell’s palsy symptoms, including:
- Ear, nose and throat evaluation
- Neurologic assessment
- Hearing test
- Vestibular test
- Tearing test
- CT scan
- MRI of the internal auditory canal and brain
- Electrophysiologic test such as an ENoG or EMG
Dr. Azizzadeh takes a holistic approach to treat Bell’s palsy. He evaluates each patient and develops a personalized treatment plan based on an individual’s symptoms. That way, patients can address Bell’s palsy symptoms and prevent them from recurring.
Bell’s palsy in pregnant women is a complex and rare condition and must be properly diagnosed and treated. To find out more about Bell’s palsy during pregnancy, please call us to schedule a consultation.
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