A case of recurrent left facial neuropathy during pregnancy

Abstract

An analysis of the features of acute facial neuropathy during pregnancy was carried out. The article considers a clinical case of recurrent left facial neuropathy during pregnancy with complete regression of symptoms after therapy. Recurrent Bell’s palsy occurred in a 35-year-old woman during her third pregnancy. In the third trimester of the second pregnancy, she had a mild left-sided prosoparesis (grade 1 on the House-Brackmann scale). The patient received corticosteroid therapy (prednisone orally), gave birth on time, and the paresis completely regressed after treatment. Parity between pregnancies was 2 years. During the current pregnancy, at 37 weeks, the patient developed pronounced left-sided prosopare-sis (grade 4 on the House-Brackmann scale). She received beta-methasone at a dose of 12 mg per day for 2 days. A week later, after induction of labor with oxytocin, she gave birth to a boy weighing 3,765 g, body length was 51 cm. One-minute Apgar score was 8 points, five-minute Apgar score was 8 points. In the postpartum period, the patient underwent physical therapy and did mimic gymnastics. Magnetic resonance imaging performed after delivery revealed no signs of vasoneural conflict and focal lesions. Complete regression of symptoms was achieved, which is a rather rare clinical outcome in such patients. Recurrent Bell’s palsy usually occurs in pregnant women with comorbid diabetes, obesity, insulin resistance, and hypertension. In this case, there was no pronounced comorbid background. The algorithm used in obstetric practice to prevent fetal distress syndrome with betamethasone administration for 48 hours was applied in our patient. The role of interaction in the for-mat of a multidisciplinary team when managing pregnant women with neurological pathology is analyzed.