Bell’s Palsy in the Third Trimester of Pregnancy: A Case Report and Review of Management Considerations

Abstract

Facial palsy is the weakness or paralysis of the muscles of facial expression resulting from dysfunction of the facial nerve (cranial nerve VII), and may involve either upper or lower motor neuron lesions. Bell’s palsy, the idiopathic lower motor neuron type, is the most common form and occurs more frequently during pregnancy, particularly in the third trimester. We report a case of a 21-year-old primigravida at term gestation who was admitted for false labour pain secondary to a urinary tract infection (UTI). On the second day of hospitalization, she developed sudden-onset right ear pain followed by right-sided facial weakness. Neurology, ophthalmology and ENT evaluations were sought. She was diagnosed with Grade III right-sided Bell’s palsy. Early multidisciplinary assessment enabled prompt diagnosis and initiation of treatment, leading to progressive recovery and favorable maternal and fetal outcomes.

Keywords: Bell’s palsy, pregnancy, facial nerve palsy, third trimester, corticosteroids, valacyclovir.