# Hyperbaric oxygen therapy for post-partum bell's palsy associate with anti-phospholipid syndrome: a case report, literature review, and mechanistic insights

## TL;DR

A woman with antiphospholipid syndrome developed postpartum Bell's palsy and showed significant improvement after hyperbaric oxygen therapy.

## Contribution

This case report suggests hyperbaric oxygen therapy may be an effective treatment for postpartum Bell's palsy in patients with antiphospholipid syndrome.

## Key findings

- Hyperbaric oxygen therapy led to rapid and complete recovery from postpartum Bell's palsy.
- Anti-dsDNA antibodies, previously positive, became negative following hyperbaric oxygen therapy.
- Hyperbaric oxygen therapy may improve outcomes through enhanced oxygenation and vascular repair in high-risk patients.

## Abstract

Bell's palsy, the most common cause of acute facial paralysis, can occur more frequently during pregnancy and postpartum due to physiological changes such as fluid retention, hormonal shifts, and immune modulation. Antiphospholipid syndrome (APS), an autoimmune disorder characterized by thrombosis and pregnancy related complications, further increases the risk of microvascular ischemia affecting cranial nerves.

We report the case of a 37-year-old woman with longstanding APS who developed postpartum Bell's palsy unresponsive to corticosteroid therapy. Despite receiving 60 mg of prednisone, no clinical improvement was noted. Hyperbaric oxygen therapy (HBOT) was initiated, prescribed for 20 sessions at 2 absolute atmospheres, 5 days per week. Remarkable improvement was observed after the first session, with complete symptom resolution by the twelfth session. Additionally, anti-dsDNA antibodies, previously positive during pregnancy, became negative following HBOT.

HBOT may represent a valuable adjunctive treatment for postpartum Bell's palsy in high-risk populations such as those with APS, offering combined benefits of enhanced oxygenation, inflammation control, and vascular repair. Further prospective studies are warranted to validate these findings and define standardized treatment protocols.