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

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

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

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

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

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* 6. How severe was your paralysis?

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

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

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* 9. Were you treated with steroids?

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* 10. Were you treated with antiviral medication?

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

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

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

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* 14. Did you have preeclampsia during any of the following periods:

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* 15. Did you have depression during any of the following periods:

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* 16. Did you have hypocalcemia (low calcium level in blood) during any of the following periods: 

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* 17. What was your age at the start of pregnancy? 

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* 18. What was your height at the start of pregnancy?

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* 19. What was your weight at the start of pregnancy?

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* 20. How much weight did you gain in the first trimester of pregnancy?

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* 21. How much weight did you gain in the second trimester of pregnancy?

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* 22. How much weight did you gain in the third trimester of pregnancy?

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

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

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* 25. When did you fully recover?

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

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

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