Emotional recognition deficits in pregnancy-onset Bell’s Palsy

Purpose Bell's palsy during pregnancy or puerperium is understudied in terms of emotional processing. The objective is to describe motor recovery and investigate facial emotion recognition in women who developed facial palsy during pregnancy or puerperium. Methods In this prospective observational monocentric study, 39 adult women who had unilateral idiopathic facial palsy during pregnancy or within six weeks postpartum completed facial motor assessments, self-report anxiety and affectivity questionnaires, and a validated computerized facial emotion recognition test Emotest-VA. Results 79.5% of patients developed palsy in the third trimester of pregnancy. Sequelae was common, with 59% of patients requiring botulinum toxin injections. Emotion recognition accuracy was significantly reduced compared to normative data (Z=-2.35; p=0.019), 6 patients had pathological scores. Greater smile asymmetry was associated with poorer emotion recognition (n = 39, r=-0.367, p=0.021). No significant links were found between emotion recognition and anxiety or affectivity questionnaire scores. Conclusion Facial palsy occurring during pregnancy or puerperium is associated with long-term facial dysfunction and reduced ability to recognize emotions on others' faces.