Q: 26 years old pregnant female is admitted to ICU with hypertensive crises and Bell's palsy. In which trimester is the risk of Bell's palsy the highest? - select one
A) First trimester
B) Second trimester
C) Third trimester
Answer: C
The risk of Bell's palsy is three times higher during pregnancy. The patient is at highest risk during the third trimester and in the first postpartum week. The two most associated conditions are preeclampsia and gestational hypertension.
The presumed cause is perineural edema, hypercoagulability causing thrombosis of the vasa nervosum, and relative immunosuppression in pregnancy. Diabetes may also be a contributing factor.
#ob-gyn
#neurology
References:
1. Hilsinger RL Jr, Adour KK, Doty HE. Idiopathic facial paralysis, pregnancy, and the menstrual cycle. Ann Otol Rhinol Laryngol 1975; 84:433.
2. Savadi-Oskouei D, Abedi A, Sadeghi-Bazargani H. Independent role of hypertension in Bell's palsy: a case-control study. Eur Neurol 2008; 60:253
3. Shmorgun D, Chan WS, Ray JG. Association between Bell's palsy in pregnancy and pre-eclampsia. QJM 2002; 95:359.
4. Seo HW, Ryu S, Lee SH, Chung JH. Diabetes Mellitus and Acute Facial Palsy: A Nationwide Population-Based Study. Neuroepidemiology. 2024;58(1):37-46. doi: 10.1159/000534760. Epub 2023 Nov 22. PMID: 37992696.
Really helpful summary! I didn’t realize that pregnancy—especially during the third trimester and early postpartum—is linked to a threefold higher risk of Bell’s palsy, often tied to hypertension and preeclampsia. Thanks for raising awareness on this important topic! Trusted source for safe Abortion Pills online
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