Bell’s palsy in pregnancy as a prodromal sign of preeclampsia: A report of three cases, pregnancy outcome, and literature review

Tadele Melese Benti, Mercy Nassali, Jemal Z. Shifa, Dereje Habte

Abstract

Bell’s palsy is a less common neurological disorder in the general population. Its occurrence during pregnancy can be used as a predictor of adverse obstetric outcomes including preeclampsia and its complications. We report cases of three pregnant women from Botswana who presented with Bell’s palsy in the third trimester coexisting with preeclampsia and multiple complications. One of the patient was a case of maternal near-miss with multiple life threating complications including stage 3 acute kidney injury (AKI) and required hemodialysis. The second and third patients developed Bell`s palsy and preeclampsia at term, management of preeclampsia commenced with immediate delivery resulting in good maternal and neonatal outcome. In all the three patients preeclampsia and Bell`s palsy completely resolved post-delivery. Therefore, new onset Bell’s palsy in pregnancy may be used as a prodromal sign of preeclampsia. Such patients deserve close follow up for preeclampsia or gestational hypertension for a better obstetric outcome. (Afr J Reprod Health 2021; 25[3]: 135-141).

Full Text:

PDF

References

Tiemstra JD and Khatkhate N. Bell's palsy: diagnosis and

management. Am Fam Physician. 2007; 76: 997-1002.

Kovo M, Sagi Y, Lampl Y and Golan A. Simultaneous

bilateral Bell's palsy during pregnancy. Journal of Maternal-Fetal and Neonatal Medicine. 2009; 22: 1211-3.

Bell S C. The nervous system of the human body.

Archives of Neurology. 1969; 21: 662.

Hilsinger Jr R, Adour K and Doty H. Idiopathic facial

paralysis, pregnancy, and the menstrual cycle. The Annals of otology, rhinology, and laryngology. 1974; 84: 433-42.

Deshpande AD. Recurrent Bell's palsy in pregnancy. The

Journal of Laryngology & Otology. 1990; 104: 713-4.

McGregor J, Guberman A, Amer J and Goodlin R.

Idiopathic facial nerve paralysis (Bell's palsy) in late pregnancy and the early puerperium. Obstetrics and gynecology. 1987; 69: 435-8.

Katz A, Sergienko R, Dior U, Wiznitzer A, Kaplan DM

and Sheiner E. Bell's palsy during pregnancy: Is it associated with adverse perinatal outcome? The Laryngoscope. 2011; 121: 1395-8.

Shmorgun D, Chan WS and Ray J. Association between

Bell's palsy in pregnancy and pre‐eclampsia. Qjm. 2002; 95: 359-62.

Mylonas I, Kästner R, Sattler C, Kainer F and Friese K.

Idiopathic facial paralysis (Bell’s palsy) in the immediate puerperium in a patient with mild preeclampsia: a case report. Archives of gynecology and obstetrics. 2005; 272: 241-3.

Shapiro J, Yudin M and Ray J. Bell's Palsy and Tinnitus

during Pregnancy: Predictors of Pre-eclampsia?: Three Cases and a Detailed Review of the Literature. Acta oto-laryngologica. 1999; 119: 647-51.

Organization WH. Evaluating the quality of care for

severe pregnancy complications: the WHO near-miss approach for maternal health. 2011.

Aditya V. LMN Facial Palsy in Pregnancy: An

Opportunity to Predict Preeclampsia—Report and Review. Case reports in obstetrics and gynecology. 2014; 2014.

O Pourrat1 J-PNaFP. Bell’s palsy in pregnancy:

underlying HELLP syndrome or pre-eclampsia? . Obstetric Medicine 2013; 6: 132–3.

Ragupathy K and Emovon E. Bell’s palsy in pregnancy.

Archives of gynecology and obstetrics. 2013: 1-2.

Gowri V and Rao K. Bell’s palsy complicating pregnancy.

Neurosciences 2005; Vol. 10 (2) 188.

May M and Schaitkin B M. The facial nerve. Thieme,

ISBN-10: 1604060506.

Davison JM. Edema in pregnancy. Kidney international

Supplement. 1997; 59: S90-6.

Voitk AJ, Mueller JC, Farlinger DE and Johnston RU.

Carpal tunnel syndrome in pregnancy. Canadian Medical Association Journal. 1983; 128: 277.

Mueanchoo P, Tepparak N, Kongkamol C, Soonthornpun

S and Sathirapanya P. The prevalence of metabolic syndrome in non diabetic patients with a previous history of Bell’s palsy. Health. 2012; 4: 203-6.

Mathieu N and Ledigabel J. Pre-eclampsia and facial

paralysis]. Gynécologie, obstétrique & fertilité. 2011; 39: e31.

Peitersen E. Bell's palsy: the spontaneous course of 2,500

peripheral facial nerve palsies of different etiologies. Acta oto-laryngologica. 2002; 122: 4-30.

Salinas RA, Alvarez G, Daly F and Ferreira J.

Corticosteroids for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2010; 3.

Sullivan FM, Swan IR, Donnan PT, Swan IRC, Morrison

JM, Smith BH, McKinstry B, Davenport RJ, Vale LD, Clarkson JE and Hammersley V. Early treatment with prednisolone or acyclovir in Bell's palsy. New England Journal of Medicine. 2007; 357: 1598-607.

Axelsson, Sara B, Thomas J, Lars E, Mats K, Mervi P,

Anne SD and Annal. Prednisolone in Bell's palsy related to treatment start and age. Otology & Neurotology. 2011; 32: 141-6.

Quant EC, Jeste SS, Muni RH, Cape AV, Bhussar MK

and Peleg AY. The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis. BMJ: British Medical Journal. 2009; 339.

Numthavaj P, Thakkinstian A, Dejthevaporn C and Attia

J. Corticosteroid and antiviral therapy for Bell's palsy: A network meta-analysis. BMC neurology. 2011; 11: 1.

Baugh RF, Basura GJ, Ishii LE, Schwartz, Seth R,

Drumheller C M, Burkholder R, Deckard N A, Dawson C, Driscoll C and Gillespie MB. Clinical practice guideline: Bell’s palsy. Otolaryngology–Head and Neck Surgery. 2013; 149: S1-S27.

Teixeira LJ, Valbuza JS and Prado GF. Physical therapy

for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2011: Cd006283.

McAllister K, Walker D, Donnan PT and Swan I. Surgical

interventions for the early management of Bell's palsy. Cochrane Database of Systematic Reviews. 2013.

Refbacks

  • There are currently no refbacks.