* 1. Did you have swelling/fluid retention during any of the following periods:

* 2. Did you have gestational diabetes during any of the following periods:

* 3. Did you have elevated sugar levels during any of the following periods:

* 4. Did you have high blood pressure during any of the following periods:

* 5. Did you have a pregnancy during which you developed facial palsy?

* 6. How many successful pregnancies did you have prior to the pregnancy related to facial palsy?

* 7. Have you ever had facial palsy before developing it during pregnancy, and if so, was it on the same side?

* 8. At what point in your pregnancy did you develop facial palsy?

* 9. What were your symptoms just prior to/at the time of onset? Check ALL that apply.

* 10. How severe was your paralysis?

* 11. Is your paralysis unilateral (one side) or bilateral (both sides)?

* 12. How long after the onset of facial palsy did you receive medical intervention?

* 13. Were you treated with steroids?

* 14. Were you treated with antiviral medication?

* 15. Have you ever had fertility issues that were managed with fertility treatment?

* 16. What was your age, height, and weight at the start of your pregnancy?

* 17. How much weight did you gain during your pregnancy?

* 18. When did you fully recover?

* 19. Has any blood relative ever had facial palsy from unknown causes?

* 20. Are there any other medical conditions that you were diagnosed with during your pregnancy?

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