Treating Bell's palsy in pregnancy

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I recently saw a 26-year-old woman in my clinic with right-sided Bell's palsy. However, the patient was three weeks pregnant. What are the options for treating Bell's palsy in early pregnancy? Is it safe to use steroids or acyclovir in the first trimester?—Shailendra K. Saxena, MD, PhD, Omaha

There is some evidence that corticosteroids administered in the first trimester of pregnancy have a teratogenic effect on jaw development in the fetus. There is no evidence that acyclovir administered during pregnancy is teratogenic. However, the beneficial effect of each of these agents on Bell's palsy is controversial.—Daniel R. Mishell Jr, MD (137-3)
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