title: Bilateral Bell palsy as a presenting sign of preeclampsia.
abstract: BACKGROUND
  Bell palsy is a facial nerve neuropathy that is a rare disorder but occurs at higher frequency in pregnancy. Almost 30% of cases are associated with preeclampsia or gestational hypertension. Bilateral Bell palsy occurs in only 0.3%-2.0% of cases of facial paralysis, has a poorer prognosis for recovery, and may be associated with a systemic disorder.
  
  
  METHODS
  We describe a case of a 24-year-old primigravid woman with a twin gestation at 35 weeks diagnosed initially with bilateral facial palsy and subsequently with preeclampsia. She then developed partial hemolysis, elevated liver enzymes, and low platelet count syndrome, prompting the diagnosis of severe preeclampsia, and was delivered.
  
  
  CONCLUSIONS
  Bilateral facial palsy is a rare entity in pregnancy that may be the first sign of preeclampsia and suggests increased severity of disease, warranting close monitoring.
authors.affiliation: Department of Obstetrics and Gynecology, Jefferson Medical College, and the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Alison
authors.initials: A
authors.lastname: Vogell
authors.forename: Rupsa C
authors.initials: RC
authors.lastname: Boelig
authors.forename: Joanna
authors.initials: J
authors.lastname: Skora
authors.forename: Jason K
authors.initials: JK
authors.lastname: Baxter
mesh_terms: D020330:Bell Palsy / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis; D011247:Pregnancy; D059285:Pregnancy, Twin; D055815:Young Adult