Onset of bell's palsy in late pregnancy and early puerperium is associated with worse long-term outcomes.

Abstract

INTRODUCTION:

The incidence of Bell's palsy (BP) is elevated in the late phases of pregnancy. Controversy exists as to whether pregnancy is a risk factor for worse outcomes in BP, and whether such outcomes are the result of factors intrinsic to pregnancy or the tendency to withhold medical therapy in this cohort.

METHODS:

Long-term facial function outcomes in cases of pregnancy-associated BP (PABP) were compared against outcomes in cases affecting nonpregnant adult women of child-bearing age by a blinded expert using the electronic clinician-graded facial function scale (eFACE) facial grading system.

RESULTS:

Fifty-one pregnancy-associated cases and 58 nonpregnancy-associated cases were included. Among patients who received early corticosteroid therapy, significantly worse static, synkinesis, and composite facial function eFACE scores were demonstrated among cases of PABP compared to nonpregnancy-associated cases (static median = 86 vs. 92.5, P = 0.005; synkinesis median = 79 vs. 86, P = 0.007; composite median = 78 vs. 84, P = 0.023). Among those not treated with corticosteroids, significantly worse dynamic and composite facial function eFACE scores were demonstrated in cases of PABP compared to those for nonpregnancy-associated cases (dynamic median = 74 vs. 92.5, P = 0.038; composite median = 73 vs. 86.5, P = 0.038). A trend toward improved outcomes was demonstrated within both groups for those treated with corticosteroids compared to those who were not.

CONCLUSION:

In comparison to cases unrelated to pregnancy, late-term PABP is associated with worse long-term outcomes to a degree that cannot solely be explained by differences in medical therapy.

LEVEL OF EVIDENCE:

4. Laryngoscope, 127:2854-2859, 2017.

• Authors: Katie M Phillips, Alyssa Heiser, Robert Gaudin, Tessa A Hadlock, Nate Jowett
• Journal: The Laryngoscope (Laryngoscope) Vol. 127 Issue 12 Pg. 2854-2859 (12 2017) ISSN: 1531-4995 [Electronic] United States
• PMID: 28349542 (Publication Type: Journal Article)
• Copyright: © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Chemical References

• Adrenal Cortex Hormones

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Bell Palsy (complications, diagnosis, drug therapy)
• Female
• Humans
• Pregnancy
• Pregnancy Complications (diagnosis, drug therapy)
• Pregnancy Outcome
• Pregnancy Trimester, Third
• Puerperal Disorders (diagnosis, drug therapy)
• Risk Factors