Bell's paralysis is a disorder in the operation of the facial nerve, which in most cases causes unilateral paralysis. Sometimes there is weakness in the muscles of the face on one side. This pathology usually develops at a rapid pace. As a rule, people older than sixty years old are subject to it, but Bell's paralysis can be observed at any age.
Usually, pathology does not need special therapy: for 1-8 weeks it passes by itself - it is this period that is required to restore the functioning of the facial nerve. However, in the elderly, recovery may take longer. In the affected area of the face, there is sometimes a persistent contraction of the muscles, and after a certain period of time the paralysis returns again.
Causes of Bell's palsy
Reliable causes of the onset of this disease are not fully understood. It is known only that the mechanism of the appearance of such paralysis has a connection with edema of the facial nerve, which occurs as a result of an immune disorder or viral defeat.
The infection most often leads to the development of this disease. Also, the factors that cause its development, are traumatic injuries and hypothermia.
This pathology can be a complication of mumps, otitis, inflammatory processes occurring in the brain. Sometimes the development of paralysis of the facial nerve as a consequence of the introduction of analgesics in the lower alveolar nerve.
Symptoms of
Bell's paralysis has very characteristic manifestations:
- Pain behind the ear. Quite often this symptom appears before the development of weakness in the muscles of the face.
- Absence of facial expressions on the affected side. Sometimes people are severely shortened muscles located on the opposite side.
- Weak musculature. It can develop in a few hours and lead to complete paralysis.
- Extension of the ocular gap. This leads to the fact that the sick person can not close the affected eye.
- Numbness or heaviness in the face. In this case, the sensitivity does not disappear.
- Disturbance of tear and salivation, taste sensitivity. This symptom usually occurs in the case of proximal lesions. Hyperacusis may develop.
Treatment
The tactics of treating Bell's paralysis are selected based on the degree of nerve damage. If some functions are retained, they can be completely restored within a few months. In other cases, medicamentous or surgical treatment is used.
Conservative treatment methods
With complete paralysis, it is necessary to perform electromyography and to investigate nerve conduction. If it is present, the chances of a full recovery are 90%.In other cases, the probability of a favorable outcome does not exceed 20%.
Drug therapy is the use of glucocorticoids in the early stages - these drugs are administered within 48 hours after the onset of the disease. Thanks to them, it is possible to reduce the duration and severity of residual paralysis.
Antiviral agents that help combat the herpes virus can also be prescribed. It can be:
- acyclovir;
- famciclovir;
- valaciclovir.
To prevent the drying of the cornea, instillation of an isotonic solution or natural tear may be prescribed. Also, a dressing is applied to the diseased eye, especially at night.
Vitamin preparations are prescribed for the 5th-7th day of the disease, and for 7-10 days - funds to improve the conduct on the nerve.
The following procedures should be mandatory:
- laser therapy;
- infrared rays;
- medical gymnastics;
- electric field of UHF;
- sinusoidal modulated currents;
- massage of the collar area;
- ultrasound;
- acupuncture.
Surgical intervention
If the symptoms persist for more than a month, surgery may be necessary. If you postpone the operation for more than three months, the pathology may persist forever.
In this case is shown carrying out microscopic decompression of the facial nerve .During this procedure, the doctor removes the bone that covers the facial nerve to open its shell. To accelerate the recovery process, an electric stimulator can be used.
After performing such an intervention, the physiotherapist appoints special exercises for the muscles of the forehead, cheeks, mouth, eyelids, chin. Thanks to these procedures it is possible to achieve full recovery.
In people with Bell's palsy for more than 2 years, facial muscles do not function. Such patients are shown plastic reconstruction, which is carried out by transposition of the facial nerve from the other side.
In addition, the Gracilis muscle is transplanted, which is located on the inner surface of the thigh. It can be transplanted to the face with vessels and nerves. This operation is used to restore the middle of the forehead and eyes in people who have congenital or long-standing Bell's paralysis. It is with these types of paralysis that the native musculature of the face is completely absent due to severe atrophy or congenital causes.
Elena Malysheva in her program tells in detail and intelligently about the peculiarities of this disease:
To prevent this from happening, when the first manifestations of pathology occur, you need to seek help from a specialist. As a preventive measure, it is advisable to avoid infectious diseases, hypothermia, and also to treat arterial hypertension on time.