title: Onset of bell's palsy in late pregnancy and early puerperium is associated with worse long-term outcomes.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  4. Laryngoscope, 127:2854-2859, 2017.
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Katie M
authors.initials: KM
authors.lastname: Phillips
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Alyssa
authors.initials: A
authors.lastname: Heiser
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Robert
authors.initials: R
authors.lastname: Gaudin
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Tessa A
authors.initials: TA
authors.lastname: Hadlock
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Nate
authors.initials: N
authors.lastname: Jowett
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D020330:Bell Palsy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011644:Puerperal Disorders / Q000175:diagnosis / Q000188:drug therapy; D012307:Risk Factors
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Bell's palsy; Pregnancy; antivirals; corticosteroids; facial palsy; facial paralysis; outcomes; puerperium; third trimester; valacyclovir