You have just had a baby and are extremely exhausted and happy. Within two days you go home and start with an earache and realize you now cannot speak. Fearing you are having a stroke you call your physician who examines you to determine you have Bell’s Palsy. This recently happened to my niece.
Bell’s Palsy is a lower motor paralysis of the seventh cranial or facial nerve. Symptoms include twitching, weakness, earache, paralysis of one of both sides of the face, drooping of an eyelid or corner of the mouth, drooling, dry eye or mouth, unable to taste, or excessive tears. The paralysis is usually only on one side of the face. People are unable to smile, eat, close their eye and often their speech is slurred. Bell’s Palsy is more common in young adults, the elderly, diabetics and often pregnant women.
Bell’s Palsy during pregnancy usually occurs during the third trimester or within several weeks of delivery. The exact causes of Bell’s Palsy with pregnancy are unknown but have been linked to the herpes simplex virus (cold sores and mononucleosis for example), excessive swelling and fluid retention during pregnancy, hypertension, or Lyme disease. Bell’s Palsy during the third trimester does not appear to have any effect on the growing fetus but pregnant women are at risk for developing preeclampsia and need their blood pressure monitored closely. Your physician may order blood tests to rule out diseases, a hearing test, a CT scan or MRI to rule out a stroke or a lumbar puncture to check for signs of infection or bleeding post partum.
Treatment includes antiviral drugs such as acyclovir if caused by a virus. If your physician believes Bell’s palsy is caused by inflammation, you may be given corticosteroids, such as prednisone. If pregnant, treatment may be supportive as antiviral medications and steroids are not usually recommended for pregnant women. The extent of the damage to your nerve determines your recovery time. Recovery during pregnancy is usually six months or less.
At home, you may be asked to perform simple facial muscle exercises to make them stronger. Artificial tears for dry eyes or an eye patch may be prescribed. For dry mouth or trouble swallowing, eat slowly while chewing food thoroughly and brush and floss your teeth often.
“Bell’s Palsy in pregnancy and the puerperium”, Journal of Family Practice, May 1993 by Anne D. Walling