Facial nerve paresis is a disease of the nervous system that develops in a few days quite unexpectedly for the patient. The ailment is immediately noticeable - there is an asymmetry of the muscles in one half of the face, which changes the appearance of the person not for the better. Most often, the cause of paresis is a cold infection of the upper respiratory tract, but there are several more disease-provoking factors. Paresis of the facial nerve can be completely eliminated, provided that the ill person on time will seek medical help and completely undergo a course of therapy.
Facial nerve paresis
The disease does not belong to rare diseases of the nervous system, about 20 people are identified for every one hundred thousand of the population.
The average age of patients with a neurologic with this disease is about 40 years, equally men and women suffer from the disease, the development of the disease also occurs in childhood.
The facial nerve refers to the nerves responsible for the motor and sensitive work of the muscles on the face. As a result of its defeat, nerve impulses do not pass in the proper volume, the muscles become weakened and can no longer perform their basic function in the right amount.
The facial nerve is also responsible for innervation of the lachrymal and salivary glands, taste buds on the tongue, sensitive fibers of the upper layer of the face. When neuritis in the pathological process, as a rule, one of its branches is involved, so the symptoms of an ailment are noticeable only on one side.
In adults, paresis of the nerve on the face can lead to discomfort, lower self-assessment, a long-term disease is often a consequence of tumors. Signs of the disease can also occur after surgery performed on the middle ear and jaw.
At the beginning of the timely treatment of the child facial facial is fully restored, on the other hand, if therapy is not available, then children have much more complications. The most severe of them include deafness, in some cases, decreased visual function.
Newborn babies can already be born with the paresis of the branch of the facial nerve. The causes of the pathology in this case are several - birth trauma, the application of forceps to the skull, infectious diseases of the mother during the period of gestation.
You can suspect paresis of the facial nerve in a newborn baby on the lowered corner of the lip on the one hand, on violations during breastfeeding. With mild forms of the disease, the pathology can be corrected after professional massage sessions.
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Types of paresis of the facial nerve
Paresis of the facial nerve is divided into peripheral and central, the first is detected more often.
Peripheral paresis
Most people who have fallen ill begin with severe pain behind the ear or in the parotid region. One side is affected, while palpation of the muscles is flaccid, their hypotension is noted.
The disease develops under the influence of inflammation, which leads to swelling of the nerve fibers and to their compression in the narrow channel through which they pass. Peripheral paresis, developing on such etiology, has received the name of Bell's paralysis.
Central paresis
It is detected much less often, with this form of a disease the muscles located in the lower part of the face are affected, the forehead and eyes remain in a normal physiological position, that is, the patient easily wrinkles the frontal folds, the eye functions completely, closes without a crack, changes in taste do notit is noted.
With palpation, the muscles at the bottom of the face are tense, in some patients there is a bilateral lesion. The cause of the central paresis of the facial nerve is the ongoing lesions of neurons of the brain.
On a schematic photo shows lesions of various muscles with paresis of the facial nerve:
Congenital paresis of
This lesion of the facial nerve accounts for approximately 10% of cases of the total number of patients diagnosed with this pathology. With a mild and moderate form, the prognosis is favorable, with severe possible assignment of one of the types of surgery.
Congenital anomaly of the facial nerve should be distinguished from Mobius syndrome, with this pathology the lesions of other nervous branches of the organism are fixed.
Causes of pathology
Paresis of branches of the facial nerve occurs under the negative influence of a wide variety of causes.
- In the first place is idiopathic, that is, primary paresis, it develops after severe hypothermia of one part of the head or parotid region.
The cause of this form of neuritis is also the transferred respiratory diseases of the upper respiratory tract. Overcooling of the head can be obtained sitting under the air conditioning, when traveling in transport with an open window.
- On the second place among the causes of paresis put otogennuyu neuropathy - the nerve is affected with otitis and during operations.
- The most rare cause is the negative impact of the herpes virus, possibly the development of paresis in tuberculosis, syphilis, parotitis and poliomyelitis.
For all of the above reasons, there is an inflammatory process, and paresis can develop under the influence of a violation in the blood supply of the face. This occurs with ischemic strokes, a sharp increase in blood pressure, with diabetes, multiple sclerosis.
Symptoms and manifestations of
The most basic function of the branches of the facial nerve is motor, that is, the nerve provides the mobility of the muscles responsible for the facial expression.
In the absence of a nerve impulse, the symptoms are primarily manifested in the inability to perform mimic movements.
The paresis of the facial nerve is divided into an acute stage, lasting up to 2 weeks, the subacute phase lasts up to one month.
If the disease is not cured in a month, then we are talking about the chronic stage of the disease.
On the side of the lesion, the following manifestations are noticeable:
- Smoothing of the nasolabial fold.
- The corner of the mouth is lowered.
- The eyelids are wide open, when they are closed, there is a lagophthalmus - there remains a bright, visible band of sclera.
- The taste sensations on the first third of the tongue surface are reduced or completely ceased.
- The function of the eyes is broken - there is dryness or vice versa lacrimation. Noticeable allocation of tears occurs when you take and chew food.
- The patient can not stretch the lips, perhaps the flow of food from the half-open half of the mouth.
- In the first days of the disease there is a worsening of hearing - there is soreness with loud sounds.
- Before the development of all the symptoms there is a sharp soreness behind the ear.
- The attempt to wrinkle the forehead ends in failure - the skin of this area remains completely smooth.
In addition, paresis of the facial nerve is divided into several degrees.
- Easy degree. Asymmetry of the face is not expressed strongly - a slight misalignment of the mouth on the affected side is possible, the patient with difficulty, but can frown the eyebrow muscles, completely close the eye.
- The moderate severity of is already manifested by a lagophthalmus, minor movements are noted in the upper half of the face. When asked to perform movements with the lips or inflate the cheek, their incomplete performance is noted.
- The severe degree of the paresis shows a pronounced asymmetry - the mouth is visibly skewed, the eye on the affected side is almost not closed. Simple movements are not performed, in which the facial muscles should participate.
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Diagnosis
Clinical signs of paresis in an experienced physician are not in doubt when making a diagnosis. Additionally, examination by ENT is necessary to exclude the pathology of the ear. Assign tests and examinations, which allow to identify and eliminate the underlying diseases of the cause.
This examination allows you to identify the localization of the damage, its degree and severity of the ongoing pathological process.
Treatment of
Paresis of the facial nerve is a disease in which the chances of getting rid of the disease depend on when the patient asked for qualified help.
With a chronic course of the process, it is almost impossible to restore the innervation of the nerve and a person can forever remain with a noticeable asymmetry of the face.
Complete normalization of the structure of nerve fibers occurs about six months, at which time the patient must undergo a medical course of treatment, physiotherapy sessions, massage, and do gymnastics.
How to treat the paresis of the facial nerve in this or that case is decided by the attending physician.
Medical treatment
In acute period, the doctor needs to identify the cause of the disease, remove swelling and inflammation and take measures aimed at the regeneration of nerve cells.
- Anesthesia is achieved by injection or tablet administration of analgesics and antispasmodics. They use Ketorol, Baralgin, Spazgan.
- Decongestants - Triampur, Furosemide.
- Corticosteroids are prescribed with moderate to severe degree of paresis. The use of prednisolone is necessary for the rapid removal of edema and inflammation.
- It is necessary to use vasodilator drugs - Complamine, nicotinic acid preparations.
- With a high level of anxiety, a positive effect is achieved faster after the appointment of sedatives - Relanium, Sibazon. Under the influence of these drugs, the patient calms down and at the same time, the muscle spasm is partially removed.
- Requires courses of vitamins, especially the B group.
- When eye damage is prescribed, drops of artificial tears - their application moisturizes the mucous membrane and prevents the attachment of a secondary infection that develops during drying.
- Symptomatic treatment is prescribed on the basis of secondary signs of the disease.
Surgical treatment
Surgical treatment is indicated with complete nerve rupture, which is often the case with injuries, and with congenital anomalies. The effectiveness of operations is observed only if it is carried out during the first year of the disease, then the muscles on the face are completely atrophied and the restored nerve can no longer manage them.
When a ruptured nerve is stitched, and with pathology autotransplantation is possible. The transplant is taken from the patient's leg, moved to the desired place of the face and sewn to it the branches of the nerve from a healthy, unaffected side.
Thus, the facial mimicry is further controlled by one facial nerve, after the operation there are no noticeable changes on the face skin - only the scar behind the ear remains.
Physiotherapy
The first week paresis of the branches of the facial nerve can be treated with a solux - a special lamp for light therapy. In the future, appoint UHF, phonophoresis with medicines, paraffin therapy is indicated.
Psychotherapy
The resulting distortion of the face does not work best for the patient's psyche, especially the drop in mood, depressive symptoms in people with high self-esteem. If sedatives do not help restore the habitual mood, then a consultation with the therapist is needed.
In order to prevent a prolonged course of the disease, it is necessary to consult a doctor at the first noticeable changes in appearance. For an acute period of illness, a sick leave sheet is issued, and in the early stages the disease is eliminated fairly quickly.
Homeopathy and acupuncture
Treatment of homeopathic remedies should be treated with caution - delaying more effective therapy can permanently disfigure a person's face.
In homeopathy, many drugs are made on the basis of poisonous plants, so their dosage should be strictly observed.
If you decide to use a medicine from this group, you need to find a qualified specialist and do this only after removing the acute symptoms of the disease. One of the homeopathic medicines shown for use in paralysis, paresis and neurosis is Gelzemium.
Acupuncture is also widely used for treatment.
Folk remedies
Together with the main treatment of the disease, you can use folk remedies that help restore muscle activity.
- A mixture of tinctures of motherwort, calendula, hawthorn and peony allows to normalize the state of the nervous system. Take 50 ml of tinctures, mix, add 25 ml of Corvalol and three tablespoons of liquid honey to the resulting liquid. Healing tincture is drunk before going to bed on a teaspoon for three months. Then they take a break for two months and conduct another course of treatment.
- Warming up with heat - sand or food salt is placed in dense tissue bags. Before use, they are heated to a comfortable temperature and applied to the affected side of the face, kept until cooling.
- In the affected side of the face can be rubed fir oil, which has a warming effect.
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Gymnastics
Gymnastic exercises for the face are an important stage in the restoration of the functioning of the facial nerve.
At home, you can use the following sets of exercises:
- You need to develop eyebrows, for this they raise, frown. Exercise is done in any free time.
- Inflate the cheek on the affected side with air. It is advisable to create an external resistance by pressing the fingers of the hand on the cheek area.
- Lips curl up and try to pull them forward.
- The eyes open wide and close their eyes a few times.
Consequences and prognosis of
A favorable outcome of the disease is observed in those patients who have undergone a course of treatment on time. The prognosis depends on the cause of the paresis, if it is a trauma or an oncogenic tumor, then muscle atrophy can develop.
Muscular contracture is observed in cases when the patient asked for help at the expiration of 2 to 3 months from the onset of the illness. With a contracture, the face looks like a mask, asymmetry and a healthy half are noted.
Surgical operations to restore muscle innervation result in success, if such treatment is performed on time. With muscle atrophy, it is not possible to restore completely mimic movements. With a noticeable defect, cosmetic surgery is performed.
Prevention
Since paresis of nerves on the face often develops under hypothermia, the only preventive measure is to prevent the effects of cold and drafts. They will prevent the development of paresis and timely treatment of otitis, respiratory diseases.
On the video - additional visual information on the paresis of the facial nerve: