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Case Report
Abstract
Background: Bell’s palsy is a peripheral facial nerve paralysis. The development of this is suspected to be a result of viral-induced inflammation, ischemia, immune-mediated mechanisms or idiopathic. Even though it can occur in the general population, pregnancy is a recognized risk factor. The incidence of Bell’s palsy during pregnancy and the postpartum period ranges from 60.5 to 171.6 cases per 100,000 person-years, with about 69% of pregnancy-associated cases occurring in the third trimester or within the first two months postpartum. Emerging evidence has shown an association between COVID-19 infection and an increased risk of Bell’s palsy, with studies demonstrating a 1.2- to 1.8 higher risk compared to uninfected individuals. Large cohort studies further indicate that the highest incidence of Bell’s palsy occurs within two months following COVID-19 infection.
Case Presentation: A 33-year-old pregnant woman at 28 weeks’ gestation, with a past medical history of chronic anemia, presented with left-sided facial paralysis. She disclosed that prior to the sudden onset of facial paralysis, she had COVID-19 a month prior. On physical examination, she displayed complete unilateral facial weakness involving both the upper and lower face indicating a lower motor neuron lesion. She did not present signs of ongoing rash, infection or trauma. She reported no improvement following initial outpatient treatment with oral prednisone. While she was admitted, her corticosteroid therapy was escalated to IV methylprednisolone due to persistent nausea. Once she could tolerate oral medication, she was switched to prednisone in order to complete her five-day course of corticosteroids.
Conclusions: The physiological changes associated with pregnancy may increase susceptibility to Bell’s Palsy. This case emphasizes the occurrence of Bell’s palsy in the third trimester after a COVID-19 infection which may have further exacerbated the patient’s predisposition to Bell’s palsy. Therefore, the importance of recognizing this possible association may aid evaluation and lead to optimal management in pregnant patients presenting with facial paralysis.
Recommended Citation
Gonzalez Tovar, Maria Camila; Rodriguez, Abelardo; Olonisakin, Oluwatobi; Kotte, Mounika; and Tijani, Aramide, "Bell’s Palsy in Pregnancy Following COVID-19 Infection: A Case Report" (2026). Research Symposium. 12.
https://scholarworks.utrgv.edu/somrs/2026/posters/12
Included in
Bell’s Palsy in Pregnancy Following COVID-19 Infection: A Case Report
Background: Bell’s palsy is a peripheral facial nerve paralysis. The development of this is suspected to be a result of viral-induced inflammation, ischemia, immune-mediated mechanisms or idiopathic. Even though it can occur in the general population, pregnancy is a recognized risk factor. The incidence of Bell’s palsy during pregnancy and the postpartum period ranges from 60.5 to 171.6 cases per 100,000 person-years, with about 69% of pregnancy-associated cases occurring in the third trimester or within the first two months postpartum. Emerging evidence has shown an association between COVID-19 infection and an increased risk of Bell’s palsy, with studies demonstrating a 1.2- to 1.8 higher risk compared to uninfected individuals. Large cohort studies further indicate that the highest incidence of Bell’s palsy occurs within two months following COVID-19 infection.
Case Presentation: A 33-year-old pregnant woman at 28 weeks’ gestation, with a past medical history of chronic anemia, presented with left-sided facial paralysis. She disclosed that prior to the sudden onset of facial paralysis, she had COVID-19 a month prior. On physical examination, she displayed complete unilateral facial weakness involving both the upper and lower face indicating a lower motor neuron lesion. She did not present signs of ongoing rash, infection or trauma. She reported no improvement following initial outpatient treatment with oral prednisone. While she was admitted, her corticosteroid therapy was escalated to IV methylprednisolone due to persistent nausea. Once she could tolerate oral medication, she was switched to prednisone in order to complete her five-day course of corticosteroids.
Conclusions: The physiological changes associated with pregnancy may increase susceptibility to Bell’s Palsy. This case emphasizes the occurrence of Bell’s palsy in the third trimester after a COVID-19 infection which may have further exacerbated the patient’s predisposition to Bell’s palsy. Therefore, the importance of recognizing this possible association may aid evaluation and lead to optimal management in pregnant patients presenting with facial paralysis.
