What is Bell’s palsy?
Bell’s palsy is a condition featuring paralysis, or weakness, of facial muscles, usually on just one side of the face. The condition is due to problems with the 7th cranial nerve also called the facial nerve that cannot be pinned to a detectable, direct cause, although any of the following viruses can trigger Bell’s palsy indirectly by causing inflammation: herpes simplex virus (HSV); varicella-zoster virus; Epstein-Barr virus; cytomegalovirus; adenovirus; rubella virus; influenza B virus; coxsackievirus; human immunodeficiency virus (HIV).
How common is Bell’s palsy during pregnancy?
Bell’s palsy develops in about 23 per 100,000 people each year in the United States. In young adults it happens more often in females than males. Furthermore, it occurs 3.3 times more often in pregnant women than in non-pregnant women, plus the risk of Bell’s palsy is higher for those with a pregnancy complication called preeclampsia. Diabetes also increases the risk, and more cases develop in winter than in summer.
How is Bell’s palsy diagnosed?
Doctors diagnose Bell’s palsy based on your history and physical examination, with particular emphasis on examining the cranial nerves that control the movement of your facial muscles and eyes. One very important thing that will be tested during the physical exam, for instance, is whether the paralysis or weakness on the affected side of the face includes the forehead muscles, or is limited to the lower 2/3rd of the face. If the forehead muscles are not affected, this suggests that the person may have suffered a stroke, in which case imaging of the brain becomes necessary and the situation is an emergency. If the paralysis includes the forehead, however, then Bell palsy is at the top of the list of diagnoses. Once the physical examination is complete, laboratory tests of blood samples can be performed in order to rule out other conditions or to identify potential viral causes.
Does Bell’s palsy cause problems during pregnancy?
Bell’s palsy gives the face an asymmetric appearance, plus it can lead to drying of the eye on the affected side of the face that can be severe enough to cause long-term damage to the cornea.
Does Bell’s palsy during pregnancy cause problems for the baby?
Bell’s palsy does not cause any particular problems for the baby.
What to consider about taking medications when you are pregnant or breastfeeding:
- The risks to yourself and your baby if you do not treat the Bell’s palsy
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat Bell’s palsy during pregnancy?
A group of medications called corticosteroids is the treatment of choice for Bell’s palsy. The main corticosteroids used are prednisone and prednisolone, both of which can be given as tablets that you take by mouth. These drugs are safe for use during pregnancy and are effective against Bell’s palsy, as long as the treatment begins within 3-4 days of the onset of your symptoms. Some researchers have proposed anti-viral medication for Bell’s palsy, but there is little evidence of a benefit.
Another important aspect of Bell palsy is treatment of the eyes, using artificial tears or lubricants to keep the cornea from drying out. Injections of botulinum toxin (Botox) also can play a role. These are local treatments used in the eyes (artificial tears and lubricants) or muscles around the eyes, so there are no dangers for the developing baby.
Who should NOT stop taking medication for Bell’s palsy during pregnancy?
Since corticosteroids treatment has been shown to increase the chances of complete recovery, if given within a few days of the onset of Bell palsy, every patient should continue with the prescribed treatment. Nobody should discontinue treatments given against eye dryness as this treatment is vital to prevent blindness.
What should I know about choosing a medication for my Bell’s palsy during pregnancy?
You may find Pregistrys expert reports about the individual medications used to treat Bell’s palsy here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for my Bell’s palsy when I am breastfeeding?
In order to encourage breastfeeding, doctors have taken into account the pharmacokinetics of various agents, meaning the science of how quickly the drugs move through the mothers system. With the steroid prednisolone for instance, it is known that it builds up in breastmilk mostly during the first four hours after a dose is given. Consequently, some doctors who give this agent for certain conditions will suggest that the patient wait four hours after receiving each dose, then pump out her milk and discard it, then wait for new milk to accumulate and nurse the infant from that new milk.
Some options for what to do about that missed feeding include: pumping earlier in the day and saving the milk to feed in place of the discarded milk, feeding formula for that one meal a day, or simply using formula for all feedings. A lactation consultant can help you if you would like to keep breastfeeding. The corticosteroid treatment regimen for Bell palsy generally runs only about 10 15 days (5 days for an initial treatment dose, followed by 5 10 days of tapering off the dose), so the inconvenience of pumping and dumping won’t last long.
What alternative therapies besides medications can I use to treat Bell’s palsy during pregnancy?
Eye patching is used in many cases as part of the treatment to protect the cornea. Physical therapy also can be used, consisting of facial exercises and retraining of the neuromuscular control of the facial muscles.
What can I do for myself and my baby when I have Bell’s palsy during pregnancy?
Cooperate with your physicians regarding eye care and completing the full course of your corticosteroid treatment.
Resources for Bell’s palsy in pregnancy:
For more information about Bell’s Palsy during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations:
- Mayo Clinic: Facial Paralysis
- Cleveland Clinic: Corticosteroids
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.