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

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

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

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

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

* 6. How severe was your paralysis?

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

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

* 9. Were you treated with steroids?

* 10. Were you treated with antiviral medication?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

* 25. When did you fully recover?

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

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

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