Idiopathic Facial Paralysis, Pregnancy, and the Menstrual Cycle

Abstract

The records of 42 women with Bell's palsy during pregnancy, and of 91 nonpregnant women, whose dats of onset of Bell's palsy and of the preceding menstrual cycle were precisely known, were studied for factors that might show relation between pregnancy or the menstrual cycle and Bell's palsy. Of the 42 cases in pregnancy, 31 occurred in the third trimester, five in the first two weeks postpartum, and six in the first two trimesters combined. Our calculated frequency of Bell's palsy in pregnant women is 45.1/100,000 births; for nonpregnant women of the same age group the calculated incidence is 17.4/100,000 per year. No causative relation was found between toxemia, hypertension or primigravidity, and Bell's palsy. Over 60% of the cases in nonpregnant women occurred in the first 14 days of the menstrual cycle with peaks on the first and seventh days and near ovulation. No clear evidence for an etiologic relationship was seen with edema or hormonal changes in either pregnancy or the menstrual cycle. A number of factors in pregnancy and the menstrual cycle suggested an etiologic role for herpes simplex virus reactivation in Bell's palsy. There was no evidence that prednisone treatment is contraindicated during pregnancy.

Epidemiologic and Clinical Features of Bell’s Palsy among Children in Northern California

“…For instance, Adour et al [12 ]found that among individuals 10–19 years of age, BP was twice as common in females and postulated that this observation may have pertained to menarche. In addition, pregnancy appears to be a risk factor for BP potentially due to physical or hormonal changes [21]. In our study, the incidence rate of BP was higher among females than males across all age strata, even among young children, and only 3 cases were pregnant at the time of diagnosis.…”

Independent Role of Hypertension in Bell’s Palsy: A Case-Control Study

“…Contrary to diabetes there is less evidence in the literature for hypertension to cause or predispose to Bell’s palsy in the general population [5,6,7,12,13,14,15,28,29,30]. There has been more attention on hypertension in Bell’s palsy among children and pregnant women [31,32,33,34,35,36,37]. The incidence of Bell’s palsy is significantly higher during the last trimester of pregnancy and the puerperium.…”

Periphere Fazialisparese in der Schwangerschaft

“…Kortikosteroiden ist im HNO-ärztlichen Bereich anerkannt Auch die Prognose der Fazialisparese in der Schwangerschaft wird uneinheitlich beurteilt [6,13,20]. Hierbei scheint die inkomplette periphere Fazialisparese eine günstigere Prognose zu haben als die vollständige Gesichtsnervenlähmung, bei der Defektheilungen in bis zu 50% der Fälle beschrieben sind [20,24].…”

“…Für die Normalbevölkerung wird eine Inzidenz von 20-30/100.000 mit einem Altersgipfel zwischen 20 und 35 Jahren und einem bilateralen Auftreten in bis zu 2% der Fälle angenommen [22]. In der Schwangerschaft und Stillzeit ging man bisher von einer signifikant höheren Inzidenz aus [2,13].…”

“…Vrabec et al [29] führten eine kritische Analyse der Daten von Hilsinger et al [13] durch. Danach gibt es keinen Beweis, dass Fazialisparesen in der Schwangerschaft wesentlich häufiger als in der Normalbevölkerung auftreten.…”