Idiopatic facial nerve palsy in pregnancy – facts and myths

Idiopathic facial nerve palsy, also called Bell’s palsy, can be a challenge for clinicians if a pregnant woman reports symptoms of facial paresis. The incidence of Bell’s paralysis in pregnant women is almost three times higher than in the age group of non-pregnant women. The problem is lack of guidelines for treatment of idiopathic facial nerve palsy in this group of patients. Randomized studies, but without the participation of pregnant women, showed greater efficacy in the return of nerve function after early treatment with corticosteroids than with other methods. The dilemma concerning therapy is intensified by the fact that prognosis regarding the return of facial nerve function in pregnant women is significantly worse than in the remaining population, even though the weakness of the facial muscles is diagnosed in a young woman. This article presents an example of a patient consulted in our department and a review of current literature. We introduce recommendations for treatment of pregnant women with facial nerve palsy. Benefits, advised medicines, doses, necessary precautions and potential side effects of corticosteroids, being the only ones that have proven efficacy in the treatment of Bell's paralysis in pregnant women are discussed.