The facial nerve runs in a narrow canal, which causes its possible damage due to infections, injuries, and hormonal imbalances. When this happens, facial nerve paresis (paralysis) occurs, with possible pain. This disease usually involves weakening of the facial muscles; its symptoms are noticeable: one half of the face “sags”, the folds on it are smoothed out, and the mouth warps to one side. When it is severe, it becomes difficult to cover the eye with the eyelid.

The disease has an acute course, develops in a few hours and lasts two weeks (as can be judged from the patients’ medical histories), after which the symptoms, under therapeutic influence or on their own, weaken and go away. Treatment should be prescribed from the first days of the onset of paresis to avoid the development of complications.

When doctors talk about paresis, they mean weakened function. Paralysis means its complete loss and absence of voluntary movements.

When does paresis develop?

The main possible reasons for which the disease develops:

• traumatic brain injury;
• infectious diseases (borreliosis, herpes, chickenpox, influenza, measles, etc.);
• hypothermia (mainly, infection develops against its background);
• circulatory disorders, stroke;
• otitis;
• neurosurgical treatment;
• inflammation of the brain and its membranes;
• tumors and cysts that can compress the nerve;
• hormonal imbalance;
• autoimmune diseases.

If facial nerve paresis is diagnosed in a newborn child, the main cause is birth trauma. Much less often, nerve damage occurs in utero as a result of infection or developmental abnormalities. In an older child, the disease may develop against the background of otitis (since the facial nerve canal originates in the internal auditory canal) or during chickenpox (the facial nerve is exposed to the varicella-zoster virus).

If symptoms of paresis (paralysis) of the facial nerve are recorded, the doctor is faced with the task of finding the causes of this pathology, since it may be concomitant with a serious disease (tick-borne borreliosis, stroke, tumor). But in most cases, the exact reasons remain unknown.

Types of disease

Facial nerve palsy is divided into two types:

The first is the most common; it is its symptoms that were described at the beginning of the article. Other signs that accompany the disease:

• swelling of the cheeks when pronouncing vowels (sail syndrome);
• rolling the eye upward when trying to close it (lagophthalmos);
• pain symptoms in some areas of the face, behind the ear and in the ear, back of the head, eyeball;
• impaired diction;
• saliva leaking from the corner of the lips;
• drying of the oral mucosa;
• increased sensitivity to sounds, ringing in the ears;
• hearing loss;
• decreased taste sensitivity;
• symptoms of eye damage on the affected side: lacrimation or, conversely, drying out of the mucous membrane.

In the mild stage, peripheral paresis of the facial nerve is sometimes difficult to establish. To do this, they perform a series of tests: they close their eyes and evaluate how difficult it was to do it (one eye can be closed with effort), they stretch out their lips with a tube, frown their forehead, and puff out their cheeks.

Central paresis affects the lower part of the face - one (it is opposite to the lesion) or both.

Its main symptoms:

• weakening of the muscles of the lower facial part;
• hemiparesis (partial paralysis of half the body);
• preservation of the eye and muscles of the upper facial part;
• unchanged taste sensitivity.

Central paresis mainly occurs due to or as a result of a stroke.

Diagnostic procedures

Treatment of the disease should begin as soon as it is detected. Sometimes paresis of the facial nerve can go away on its own, but in which cases this will happen is difficult to predict.

The symptoms of the disease are quite clear, but before treatment, you must try to determine the reasons that caused the paresis (paralysis). In some cases, elimination of the underlying disease leads to restoration of the function of the facial nerve (this can happen, for example, with a brain tumor). For this purpose, tomography (computer or magnetic resonance imaging) is performed.

In addition, an examination of reflexes using an electroneuromyograph should be prescribed. The procedure allows you to evaluate the speed of impulses passing through the fibers, their number, as well as the location of the lesion. One way to determine the degree of paresis (paralysis) is to conduct electrogustometry.

This procedure is performed using an electroodontometer. An anode is applied to the front of the tongue, the electrodes are located 1.5 cm from the midline. The current strength is gradually increased until the patient registers a sensation of sour or metallic taste.

Paresis therapy

Treatment in the acute period is aimed at relieving swelling and inflammation and improving microcirculation. For these purposes the following is used:

• corticosteroids;
• diuretics;
• antiviral drugs (if the disease occurs due to herpes or chickenpox);
• antibiotics (with the development of paresis during infection, otitis media).

Gymnastics and massage can be prescribed no earlier than the third day from the onset of the disease and only under the supervision of a doctor, since independent treatment and improper use of techniques threatens the appearance of contractures and synkinesis.

1. The phenomenon of contracture consists of increased muscle tone with pain on the affected side and twitching of the facial muscles. There is a feeling of tightening of the face.
2. Synkinesis - movements that appear simultaneously with the main ones. This may include wrinkling the forehead or raising the corner of the mouth when closing the eyes. Either raising the ears or flaring the wings of the nose when closing the eyes with effort, etc.

These complications appear, as can be learned from medical histories, in 30% of all cases of facial nerve paresis. If this happens, massage and physiotherapy are temporarily canceled and the muscles are given rest.

Principles of gymnastics and massage

Therapeutic gymnastics consists of certain techniques. It could be:

• puffing out the cheeks (alternating, simultaneous);
• snorting, pronunciation of the letter “p” with a delay at the initial stage of movement;
• manual assistance when performing movements (closing eyes, wrinkling the forehead, etc.), which is performed by a specialist.

One of the recovery methods is post-isometric muscle relaxation, which is alternate short-term isometric work of the muscles and their passive stretching afterwards. This type of gymnastics is performed only under the supervision of a doctor, since it has many nuances in its implementation, failure to do which can lead to complications.

The main massage is carried out from the inside of the mouth, which allows you to define the muscles and increase blood circulation in them. In addition, acupressure is performed, since classic massage can lead to muscle strain.

During the recovery period, group B drugs and alpha-lipoic acid, UHF, and phonophoresis are also prescribed.

If the lesion is severe, treatment should be aimed at preserving the eye on the affected side of the face. Drops are used to eliminate and prevent dry mucous membranes, but if the eyelid does not droop at all, this threatens the development of keratopathy and blindness. Doctors can sew the eyelids together and insert implants into the upper eyelid to force it to droop. Currently, the injection of botulinum toxin is popular, which lasts 2-3 weeks. Injections are also effective in combating contractures and can be used for aesthetic facial correction in the future.

During the acute period of the disease, it is not recommended to treat the affected side of the face mechanically, using treatment methods such as massage and gymnastics. At home, you need to use a patch that will fix the weakened muscles on the sore side of the face. Your doctor will show you how best to do this.

Features of the course of the disease and treatment in childhood

A disease in children that is secondary in nature (that is, another disease is the cause of its occurrence) is usually accompanied by pain in the parotid region. In some cases, pain and discomfort may be experienced in various parts of the face and back of the head, depending on the location of the nerve damage.

In a child, paresis of the facial nerve usually goes away faster than in an adult. In this case, complications may be completely absent or their degree may be minimal. Symptoms of the disease in childhood are more likely to regress on their own than in adults. However, it is necessary to treat paresis, since there is no guarantee that it will go away without therapy.

In a newborn who has suffered nerve damage during childbirth, in addition to visual signs, damage to some reflexes is noted: palatine, search, sucking, proboscis. A complication that occurs with this pathology in an infant is difficulty or complete inability to suck on the mother’s breast. In this case, feeding is carried out from a bottle with a lightweight nipple.

Therapy

Treatment for paresis begins in the maternity hospital according to the standard regimen. In some cases, doctors do not use corticosteroids, since their use in infancy can lead to complications.

A child with damage to the facial nerve often suffers from hyperacusis - it is necessary to protect him from loud sounds and not use rattles.

After the maternity hospital, treatment for paresis continues on an outpatient basis: during the recovery period, massage and physiotherapy can be prescribed. At home, parents have access to therapeutic gymnastics, with the help of which reflexes are induced in the child.

1. The palmo-oral reflex is caused by pressing the parent's fingers on the middle of the child's palm: the baby's mouth opens slightly.
2. To trigger the proboscis reflex, you need to lightly touch the baby’s lips with your finger: his lips should stretch into a tube.
3. The search reflex is caused by stroking the baby's cheek near the corner of the lips, after which the baby moves his mouth towards.
4. The sucking reflex is formed thanks to the pacifier.

Also, at home, parents continue treatment with medications prescribed by the doctor. Massage, heating and any other influences should not be carried out independently - only in a clinic with a specialist. This will avoid the appearance of contractures and synkinesis.

If the pathology at birth is diagnosed as congenital, surgical treatment is indicated.

So, paresis of the facial nerve is a pathological condition that occurs acutely and is characterized by weakening of the muscles of one side of the face (peripheral paresis) or the lower facial part (with the central type). The causes of this phenomenon often remain unclear, but they may include tumors, infections, neurosurgical interventions, and in newborns, birth trauma. Treatment of the disease begins with medication from the first day to avoid complications. During the recovery period, massage and therapeutic exercises can be added.

Causes and treatment of facial nerve paresis

The facial nerve functions as a kind of motor for all facial muscles. It is also responsible for skin sensitivity. Paresis of the facial nerve characterizes the rapid development of a violation of facial symmetry. One half of the patient's face is motionless and affected by paralysis.

What is paresis?

Damage to the facial nerve develops very rapidly. In just a few days, the motor function of the affected side of the face is completely impaired.

Facial paralysis always has the same symptoms, but different causes of development.

The disease is not rare. Both men and women are equally susceptible to it, and the disease often occurs in children.

The main cause of damage to the facial nerve is infectious diseases affecting the upper respiratory tract.

The defeat results in disruption of the passage of nerve impulses along the facial nerve. As a result, the motor activity of the facial muscles is disrupted, and the skin loses sensitivity. As a rule, prosoparesis affects only half of the face, which is responsible for the pronounced asymmetry, which is the main symptom of the disease.

Causes of paresis

The most common cause of damage to the facial nerve is infectious and colds of the upper respiratory tract. Prosoparesis can also develop against the background of purulent inflammation of the middle ear (otitis media) or sinusitis.

There are often cases when paresis develops due to the presence of a tumor. Also, muscles can be paralyzed after surgery and removal of a tumor.

Dental treatment and manipulation of the patient’s jaw can also trigger the development of paralysis.

The pathology often occurs in children of preschool and primary school age. In this case, the disease is caused by the following reasons:

In childhood, complete restoration of the motor function of the facial muscles is possible, but only if treatment is started in a timely manner.

Primary paralysis is idiopathic and occurs due to hypothermia. As a rule, hypothermia causes the development of ARVI, which is often accompanied by paresis of the facial nerve. Most often, this form of the disease appears as a result of exposure to a draft and ranks first among all cases of disease of the facial nerve.

The second place in the frequency of cases is occupied by prosoparesis, caused by purulent inflammation of the middle ear or surgical intervention in the jaw, maxillary sinuses or ear canal of the patient.

Very rarely, paresis of the facial nerve develops as a result of tuberculosis, the action of the herpes virus or syphilis. Such cases are quite rare, but they do occur.

An indirect cause of the development of paresis can be a stroke and progressive sclerosis against the background of diabetes mellitus.

Symptoms of pathology

Damage to the facial nerve causes disruption of the passage of nerve impulses. This results in a violation of the main function of the facial nerve - ensuring the motor activity of facial muscles. Since facial paralysis often affects only one side of the face, the characteristic symptoms are difficulty moving the muscles in the affected area.

Paralysis is characterized by the following symptoms:

• drooping of the corners of the mouth and smoothing of the nasolabial fold on the affected part of the face;
• the patient cannot completely close the eye;
• disturbances in the natural hydration of the eye develop - the tear fluid is either insufficient or too much;
• difficulty chewing food develops due to weakening of the muscles around the mouth;
• loud sounds cause discomfort;
• the patient cannot frown.

Depending on the severity of facial asymmetry, mild, moderate and severe degrees of paralysis are distinguished. In mild forms of the disease, there is slight distortion of the corners of the mouth, and the motor activity of the facial muscles is difficult, but not completely paralyzed.

Moderate disease is characterized by worsening symptoms. The lower part of the face is motionless, but motor activity in the eyebrow area is still present.

The severe form is characterized by a visible violation of the symmetry of the face, and there is a significant distortion of the diseased side in relation to the healthy one. Motor activity of the muscles is completely absent, the patient cannot control facial expressions.

Paresis in infants

Paresis of the facial nerve in a newborn may be a congenital pathology in the infant. In this case, the disease is caused either by birth trauma or infectious diseases suffered by the mother during the period of bearing the child.

Often, paralysis of the facial muscles is observed during complicated childbirth, when forceps were applied to the child’s head, or vacuum extraction was performed.

A characteristic external manifestation of paresis in newborns is weakening of one side of the mouth. The baby's lips are lowered and feeding is difficult.

As a rule, the situation in infants can be corrected with the help of massage. With timely treatment, paralysis is completely cured, the motor functions of the facial muscles are restored, and the risk of developing any complications is minimal.

Congenital paresis of the facial nerve in newborns, not caused by birth trauma, is treated depending on the degree of nerve damage. For mild to moderate illness, recovery is achieved through massage and drug therapy, but for severe paresis, surgical intervention may be necessary.

Types of nerve damage

There are two types of pathology - central paresis and peripheral.

Central paresis is characterized by damage to the lower facial muscles. External asymmetry may be absent. The patient does not experience difficulty moving his eyes, he can frown or relax his forehead, but the muscles around the jaw and cheeks are tense, and there is no facial expression in this area.

Central paresis is rare and is caused by damage to the neural network of the brain.

In 85% of cases, doctors diagnose peripheral paresis. The onset of the disease is characterized by pain behind the ear. When palpated, it feels lethargic and lacks muscle tone. As a rule, the disease affects only one side of the face, which causes visible asymmetry.

The cause of peripheral paresis is an infectious disease and inflammatory process. As a result, swelling of the nerve fibers is formed and their further compression, which causes paralysis of the facial muscles.

Bell's palsy

Bell's palsy is a disorder of facial expression due to damage to the facial nerve. Paresis (prosoparesis) and Bell's palsy have similar symptoms: the disease affects one side and is characterized by visible asymmetry of facial features.

The disease is accompanied by the formation of nerve edema. The causes of Bell's palsy are hypothermia, impaired immunity and infectious lesions of the body.

This form of paresis is characteristic of older people and is often a secondary disease that develops against the background of progressive atherosclerosis, but children are also susceptible to paralysis.

Therapy includes taking antiviral drugs. Unlike facial paresis, Bell's palsy can be successfully treated in nine out of ten cases.

Many people are interested in whether facial nerve paresis can go away without treatment? It should be remembered that this serious disease is fraught with loss of facial function and hearing impairment, so it must be treated in a timely manner.

Facial nerve paresis, its symptoms and treatment require attention from the patient. The disease cannot be started.

Conservative treatment methods

The best treatment for facial paresis depends on the severity of the disease. Conservative treatment is based on drug therapy. Treatment includes therapy with the following groups of drugs:

• non-steroidal anti-inflammatory drugs for pain relief;
• drugs to quickly get rid of swelling;
• taking antispasmodics to relieve spasm of nerve fibers;
• in severe cases of the disease, injections of corticosteroids are indicated to relieve swelling and relieve pain;
• to improve local nutrition, vasodilator drugs are used;
• moisturizing drops to normalize tear production.

Paresis is often accompanied by feelings of anxiety and sleep disturbances. In this case, taking mild sedatives before bed is indicated. As a rule, such therapy helps to quickly relieve spasms by normalizing sleep and the activity of the nervous system.

A course of vitamins to strengthen the nervous system (group B drugs) is mandatory.

Prognosis with conservative treatment

The success of a patient’s cure depends on timely consultation with a doctor.

Typically, paresis is characterized by acute and subacute forms. The acute form of the disease develops quickly, and from the appearance of the first symptoms (ear pain) to impaired facial expressions, it takes from one to two weeks. The subacute form develops within a month.

If treatment is not started at this stage, the subacute form may become chronic. In this case, surgical intervention will be required to correct the facial expression disorder.

Treatment of paresis is a long process. From the start of therapy to the restoration of facial expressions, at least six months of intensive treatment take place.

However, timely treatment guarantees the patient’s full recovery without the development of possible complications.

The chronic form of the disease is dangerous with the risk of hearing loss and decreased visual acuity due to lack of blood circulation in the affected area.

Physiotherapeutic methods

Along with drug treatment, physiotherapeutic methods are used. As a rule, electrophoresis or phototherapy is indicated for paresis. Low-frequency magnetic therapy methods are also used.

Physiotherapeutic methods are aimed at restoring normal blood flow. They help improve metabolic processes in the affected area and relieve spasm of nerve fibers.

In addition to physiotherapy, some massage techniques and acupuncture are used. All this allows you to improve local blood circulation and gradually helps restore the ability to control your own facial expressions.

Patients are shown facial gymnastics, which helps restore motor activity. It includes the following exercises:

• “frowning eyebrows” - the patient needs to frown and relax the brow ridges several times a day;
• “full cheeks” - you should puff out your cheeks as much as possible and then relax them;
• “whistle” - you need to stretch your lips folded forward as much as possible, imitating a whistle.

Exercises for developing the facial muscles responsible for the movement of the eyelid also help: the eyes should be opened as wide as possible, making a surprised face, and then relax. Gymnastics is performed up to 10 times a day, in any free minute.

However, gymnastics or massage alone cannot cure paresis, so it is necessary to combine these methods with conservative drug treatment.

The need for surgical intervention

The operation is indicated in the following cases:

• nerve rupture;
• paresis caused by trauma;
• congenital facial paralysis;
• ineffectiveness of conservative treatment for chronic disease.

In case of rupture, surgery involves suturing the damaged area of ​​the facial nerve. This intervention is quick and rehabilitation does not require a long time.

For congenital paralysis or other anomalies, nerve transplantation from other parts of the patient’s body is used.

The operation leaves no visible scars, except for a small strip behind the ear. As a result of surgical intervention, the asymmetry is successfully corrected, and difficulties with facial expressions do not arise in the future.

Treatment of newborns and children

Prosoparesis of the facial nerve in newborns is treated in the maternity hospital immediately after birth. The baby is exposed to thermal physiotherapy, which helps relieve swelling and spasm of nerve fibers.

Treatment of infants continues after discharge, at home. It involves the heat of a soft cloth applied to the affected area on the child. Loud and sudden noises should be avoided at home as they may cause discomfort to the sick child.

In order for the baby to recover faster, a massage is needed that will help quickly restore facial activity. Massage should only be performed by a specialist!

Treatment of children of primary school age is also based on physiotherapeutic methods, gymnastics and massage. Along with these methods, drug therapy is carried out, including taking antispasmodics. Young patients are required to take a course of vitamins.

Traditional treatment

Traditional methods of treatment should complement, but not replace, drug therapy prescribed by a doctor, otherwise anything can happen.

Heat exposure helps relieve swelling and spasm of nerve fibers. To do this, dry heat is used at home - heated salt is poured into a bag made of thick natural fabric and applied to the affected area.

To improve local blood circulation and relieve symptoms, you can rub slightly heated fir oil into the affected areas. It promotes vasodilation and has a slight warming effect.

For paresis, sedatives work well to relieve muscle tension and calm the nervous system. In folk medicine, peony tincture is used, which is taken before bed. A good effect is also achieved by taking a mixture of alcoholic tinctures of hawthorn and motherwort.

It should be remembered that only timely and qualified treatment will allow the restoration of facial function over time. If you follow the recommendations of your doctor, the result will not be long in coming and muscle sensitivity will be completely restored after a few months.

Treatment of facial nerve paresis. We will quickly restore your health

We continue to get acquainted with neurological diseases. And today talk about facial nerve paresis. The disease develops in a matter of days. The resulting asymmetry on one side of the face does not change a person’s appearance for the better. Timely treatment measures will help to quickly cope with the disease. Let's sort it out in order.

What is facial nerve palsy?

Facial nerve paresis is a disease of the nervous system characterized by impaired functioning of the facial muscles. As a rule, a unilateral lesion is observed, but total paresis is not excluded. The pathogenesis of the disease is based on a disruption in the transmission of nerve impulses due to trauma to the trigeminal nerve.

The main symptom indicating the progression of facial nerve paresis is facial asymmetry or the complete absence of motor activity of muscle structures from the localization of the lesion.

Most often, the cause of paresis is colds of the upper respiratory tract, but there are also several other factors that provoke the disease, which we will discuss further.

The average age of a neurologist's patients with this disease is about 40 years, both men and women suffer from the disease equally often, and the disease develops in childhood.

The facial nerve refers to the nerves responsible for the motor and sensory function of the muscles of the face. As a result of its damage, nerve impulses do not pass through in the required volume, the muscles become weakened and can no longer perform their main function to the required extent.

The facial nerve is also responsible for the innervation of the lacrimal and salivary glands, taste buds on the tongue, and sensory fibers of the upper layer of the face. With neuritis, as a rule, one of its branches is involved in the pathological process, so the symptoms of the disease are noticeable only on one side.

What symptoms can you use to recognize facial nerve paresis?

Symptoms of facial nerve paresis are divided into basic and additional.

The main symptoms include: tilting of the face to one side, partial immobility of some part of the face, a condition in which a person cannot close one eye. Also, complete immobility of the eyebrows, cheeks, or the corners of the mouth drooping downward is often observed; often a person with facial nerve paresis can be recognized by difficulty speaking.

Additional signs of the presence of facial nerve paresis include constant dry eyes or, conversely, excessive lacrimation. Almost complete loss of taste, as well as increased salivation. A person may become irritable, loud noises will get on his nerves, and the corners of his mouth will involuntarily droop.

Where are the roots of all diseases?

Our world is diverse and complex for some, but simple and great for others. The ability to behave, to subordinate thoughts to one’s will, to manage one’s condition in different situations, to launch the correct biochemical processes, allows a person to have strong energy and strong immunity, and therefore resistance to any diseases.

The integrity of the body begins to collapse with psycho-emotional factors that affect us every day. If a person knows how to cope with them, processing any emotional surges towards a positive shift forward for himself, he will be able to react easily to any uncomfortable situation, remain in good health and, moreover, develop his energy potential.

Otherwise, under the influence of a crazy pace of life, stressful situations at work, at home or on the road, a negative energy charge begins to accumulate, gradually destroying a person’s energy shell.

First, this affects a person’s psychological health; later, the destruction moves to the physical level, where internal organs begin to suffer and various sores appear.

What is the cause of facial paresis and what factors contribute to its development?

Paresis of the facial nerve can act in two qualities - an independent nosological unit, and a symptom of a pathology already progressing in the human body. The reasons for the progression of the disease are different, therefore, based on them, it is classified into idiopathic damage and secondary damage that progresses due to trauma or inflammation.

• polio
• pathogenic activity of the herpes virus
• mumps
• respiratory pathologies of the upper airways
• head injuries of varying severity
• nerve fiber damage due to otitis media
• damage to the nerve fiber during surgery in the facial area
• syphilis
• tuberculosis

Another reason that can provoke paresis is a violation of blood circulation in the facial area. This violation is often observed with such ailments as:

• multiple sclerosis
• ischemic stroke
• hypertensive crisis
• diabetes mellitus

The following types of paresis are distinguished:

Peripheral paresis

As a rule, this type of paresis begins with severe pain behind the ear or in the parotid area. One side is affected; upon palpation, the muscles are flaccid, and their hypotonicity is noted.

The disease develops under the influence of inflammation, which leads to swelling of the nerve fibers and their compression in the narrow channel through which they pass. Peripheral paresis developing according to this etiology is called Bell's palsy.

Central paresis

With this form of the disease, the muscles located in the lower part of the face are affected, the forehead and eyes remain in their normal physiological position, that is, the patient easily wrinkles the frontal folds, the eye functions fully, closes without a gap, and no changes in taste are noted.

On palpation, the muscles at the bottom of the face are tense, and in some patients there is bilateral damage. The cause of central paresis of the facial nerve is ongoing damage to the neurons of the brain.

Congenital paresis

This lesion of the facial nerve accounts for approximately 10% of cases of the total identified number of patients with this pathology. For mild and moderate forms, the prognosis is favorable; for severe cases, one type of surgery may be prescribed.

A congenital anomaly of the facial nerve must be distinguished from Mobius syndrome; with this pathology, lesions of other nerve branches of the body are also recorded.

How to recover from facial nerve paresis with Tibetan medicine?

Rapid restoration of the body using Tibetan methods occurs thanks to methods of external and internal influence. Everything that can contribute to rapid recovery is taken into account. Lifestyle and nutrition also play an important role here.

We already know that the “Wind” constitution is responsible for the nervous system. And since the occurrence of this disease is closely related to disruption of the passage of nerve impulses, it means that in order to calm the disease it is necessary to restore the harmony of the wind in the body. This is achieved precisely with the help of external and internal influence.

Methods of external influence used for paresis are aimed at resuming the passage of nerve impulses to muscle structures, normalizing the psycho-emotional state, eliminating congestion and stimulating the body’s own immune forces to resist the disease. The procedures are prescribed by the doctor, taking into account the medical history and characteristics of the patient’s mental state.

The main external influences include the following procedures:

In combination with herbal medicine, these procedures provide a tremendous healing effect and allow you to quickly relieve pain and alleviate the condition.

Properly selected herbal remedies have an immunomodulatory, antibacterial and anti-inflammatory effect, harmonizing the state of the body’s internal systems.

An integrated approach is the basis of Tibetan medicine. External influence by the above procedures leads to the following:

• Relieves inflammation and swelling
• Pain syndrome is quickly eliminated
• Reduces compression of the damaged nerve bundle
• Blood supply is normalized
• Stagnation is eliminated
• Nerve tissue is restored
• Normal muscle activity returns
• Facial expressions are restored
• Increases immunity

Tibetan medicine has helped many patients regain lost health. Even in those cases when ordinary doctors refused the patient, saying that he could no longer be helped, Tibetan medicine helped.

Not because she has some kind of magic pill, but because she has enormous knowledge about human nature and its interaction with this world. This experience has been accumulated over thousands of years and is now quickly gaining popularity due to its amazing results.

Without chemicals, antibiotics, painful procedures and surgeries, we manage to get people back on their feet, significantly improving their condition.

People also come to us to prevent diseases. Relax, unload your emotional state, raise your vitality and restore your energy.

After complex procedures, a person gains harmony with himself and the outside world for a long time. He just glows with love, energy and life.

Therefore, if you have any health problems, come, we will help you.

Health to you and your loved ones!

Questions

Question: How to treat facial nerve paresis?

During ear surgery, my wife’s facial nerve was injured, resulting in paralysis of the left side of her face. She underwent a series of physiotherapy procedures, acupuncture and sewing in threads with medications, took a bunch of antibiotic tablets and vitamins, the result was very weak. The eye closes weakly, the cheek droops, the mouth pulls to the right when speaking.

First, you need to determine the condition of the nerve using electromyography. Based on the results, treatment tactics can be determined: conservative or surgical approach. The best results are shown by complex therapy using (in addition to drug treatment) medicinal injections into the facial nerve canal, electrical myostimulation of facial muscles and a course of facial rehabilitation.

Thanks for your response! I may have missed important information. My wife is 55 years old.

Electromyography was performed, and here are the results:

WHEN STUDYING WITH SKINAL ELECTRODES: There is no spontaneous activity from the orbicularis oris and ocular muscles. With voluntary contraction, recording of reduced amplitude, rarefaction and synchronization of recording to 2 B-B type on the left.

DURING STIMULATION STUDY: The conduction velocity along the n.facialis is normal. The amplitude of the M-response from the orbicularis oculi muscle on the left is reduced to 0.75 mv, on the right 2.55 mv, from the orbicularis oris muscle on the left 1.5 mv, on the right 1.9___mv/normal from 1___mv /

M-responses on the left are deformed, expanded, TL is increased.

Conclusion: Rough axonal neuropathy n.facialis on the left.

Consult a neurosurgeon. Paresis requires long-term physiotherapeutic treatment, the use of drugs that stimulate the regeneration of nervous tissue (B vitamins, drugs containing substances necessary for restoring the myelin sheath of the nerve, improving its impulse conductivity).

3 years ago, my facial nerve was injured during surgery to remove an acoustic neuroma. Since then, the left side of my face has been paralyzed; in my opinion, there has been no improvement and no worsening either. Most doctors say that too much time has passed to wait for improvements, and inpatient treatment in neurology 2 times a year only improves the general condition. I am a woman, I am 30 years old and I still hope that my face will become healthy. Maybe you can tell me how to proceed next?!

You should contact a neurosurgeon for a face-to-face consultation, who will give an opinion on the prospects for surgical intervention.

6.5 years ago I experienced paralysis of the facial nerve, I was treated with massage, laser therapy, hirudotherapy, and B vitamins, and in the end the disease almost went away, but residual effects remained: the eye twitches (it narrowed a little) when moving the mouth or wing of the nose. Maybe I can be helped with medication?

Unfortunately, this problem cannot be solved with medication.

I really want to get rid of these twitches, if it can’t be helped with medication, then with what? Is this problem in the muscle? Is there something wrong with her or is it a damaged nerve?

Twitching of facial muscles in such cases can be caused by an error in the functioning of the subcortical nuclei of the brain, overexcitation of the centers of the facial nerve in the brain stem, or irritation of the facial nerve itself after it leaves the brain. In some cases, the administration of Botulinum toxin helps to eliminate hyperkinesis of the blinking muscle. Consult an experienced neurologist.

I have left-sided paresis, almost since birth. Now it is almost not noticeable. All the muscles on my face work, only the left half of the lips and the corner of the lips rise strongly upward when talking.

How to make your face more symmetrical? Maybe some exercises for facial expressions? Or medication?

In this case, a personal consultation with a neurologist is necessary. Only after identifying the cause of paresis will a specialist doctor be able to prescribe adequate treatment.

paresis due to left-sided cerebral palsy. But it is in a mild form. I went to a neurologist, they said that there was no way to get rid of it. I was very upset. I would be advised to do a set of exercises, I myself can feel all the muscles on my face, on the left side they are poorly developed. eyes I close it, puff out my cheeks, raise my eyebrows and forehead. Only my lips don’t work well, on the left side they are almost motionless, because of this the asymmetry of the face is noticeable. It can’t be that there’s no way to fix it. Help!

Which doctor should I contact? And which facial exercises should I choose?

Where do kinetherapists see doctors in St. Petersburg?

thank you very much for the answers!

Unfortunately, we do not have our own information base that would allow us to accurately answer your question.

Hello, please tell me, I had an injury to my eyebrows and the left corner of my eye on the right side of my face, all the muscles work fine, but I can’t feel the corner of my nose on this side and I can’t feel part of my upper lip, what is it. This muteness can be somehow treated, and often this place itches and seems to tighten! What could this be?! And in general, sensitivity will return or not?! Thank you.

In this case, there is a high probability that the altered sensitivity of this localization is caused by traumatic damage to the branches of the trigeminal nerve, which is responsible for the innervation of this area. The fact is that in case of mechanical damage to peripheral nerves, the recovery of the latter occurs quite slowly (in some cases, sensitivity may not be restored at all). To prescribe adequate treatment (including medication, physiotherapy), you need to seek a personal consultation with a neurologist. A personal consultation with a specialist doctor is necessary to assess the extent of damage and exclude possible contraindications for the required treatment. Read more about the work of the trigeminal nerve and the symptoms of its damage in articles devoted to this topic by following the link Trigeminal nerve. Perceived itching and discomfort may indicate the continued growth of peripheral nerve trunks towards the skin they innervate.

I am 23 years old. 5 years ago I was diagnosed with facial nerve paresis. I was treated for six months with medications, acupuncture, and massage, even with some kind of massage device that operates on the basis of current impulses. As a result, when I smile, a slightly residual effect of this disease is visible, even in photographs it is sometimes clear that there is a slight asymmetry. Is there anything else I can do now so that my face takes on a normal appearance and I can smile as before?

In this case, it is recommended to undergo a repeated course of therapeutic rehabilitation; after such an illness, the rehabilitation process is long, several courses of physiotherapy and drug treatment will be required to completely restore nerve function. Read more about this disease in a series of articles by clicking on the link: Facial nerve paresis.

I have had paresis since childhood, possibly since birth. Asymmetry in the smile, I don’t blink, there’s a heaviness in my cheek, and my cheek has begun to droop a little. I didn’t pay attention before, but now I understand that it greatly spoils my appearance. Is it possible to treat paresis at this stage? I am 28 years old.

There are many modern techniques to treat paresis, including electrical stimulation, acupuncture, and physiotherapy. You definitely need treatment. You need to personally consult with a neurologist so that after examination and examination the doctor can prescribe you adequate treatment. You can learn more about this from the section: Neurologist

Hello. I am 32 years old. A year ago I had the root of a tooth removed (upper left side). The doctor fussed for a long time and finally cut my gum (the cut went almost from the wing of the nose to the 6.7th tooth) and removed the root. He put several stitches. All this took a long time to heal and hurt. There was a feeling that all the nerves were outside and constantly hurt. The doctor He said that with time everything will pass. After 2 months, I installed a dental bridge. And a month later, pain appeared on the entire left side of my face. A swelling appeared in the area of ​​the nasal sinus. They took an x-ray, it turned out that a lot of fluid had accumulated there, which even began to put pressure on the eye. They pierced the nasal sinus through the gum. (And it so happened that the puncture site was exactly in the area where the gum was cut dentist) Since then I have been suffering from constant pain, both headaches and dental pain. This year I forced the dentist to remove the bridge. I thought that was where the problem lay. It turned out there was no inflammation and the bridge sat perfectly. But the pain continued. The left upper lip periodically goes numb. All the doctors shrugged and “kicked” me from one to the other. Then they advised me to undergo a course of physical therapy, perhaps the trigeminal nerve was damaged due to all the medical manipulations. With difficulty I got a referral from the dentist (that’s the only way we can do this) And now I’m doing the second course, 10 minutes with a device and a minute of acupressure. The headaches seem to have gone away, but at times there is severe pain in the area of ​​the dental bridge (a burning sensation and nagging pain of these sharpened ones teeth, the upper lip periodically goes numb). Tell me, am I being treated in the right direction, was the trigeminal nerve really damaged? Perhaps I need to see a neuropathologist. By the way, I live in Germany and these are the “miracle doctors” we have.

In this case, based on the symptoms described, damage to the trigeminal nerve cannot be ruled out. However, only a neurologist can make an accurate diagnosis and prescribe adequate treatment for you after a personal examination. Read more on this issue in the section: Trigeminal nerve

The facial nerve is responsible for the functioning of the lacrimal and sebaceous glands, facial expressions, facial sensitivity (superficial), perception of tastes and sounds. It consists of two branches, but the lesion most often affects only one of them. Therefore, usually signs of paresis are observed only on one side of the face.

Facial nerve paresis: causes

Most often, paresis develops as a result of hypothermia or previous colds. Sometimes paresis can be otogenic, occurring due to nerve damage due to inflammation of the ear (mastoiditis, otitis media) or during surgery. In rare cases, paresis of the facial nerve becomes a consequence of tuberculosis, mumps, syphilis or polio. Damage can also occur as a result of trauma to the skull.

Facial nerve paresis: symptoms at different degrees of severity

The pathological process can have different degrees of severity. In mild cases, the patient can perform actions on the affected side of the face such as wrinkling the forehead, closing the eyes, and raising the eyebrows. Of course, these manipulations are difficult, but they are still possible. The mouth barely tilts to the healthy side. If the severity of paresis is moderate, the patient cannot close his eyes completely. When you try to wrinkle your forehead or move your eyebrow, you can see some movements, but they are very insignificant. When paresis of the facial nerve is severe, the patient cannot perform any movements on the affected side of the face. The pathological process can be acute (lasting no more than two weeks), subacute (lasting up to four weeks), chronic (lasting more than four weeks).

Facial nerve paresis: characteristic signs

With unilateral paresis of the facial muscles, the affected side becomes like a mask: wrinkles on the forehead (if any) and nasolabial folds are smoothed out, the corner of the mouth droops. When a person tries to close his eyes, complete closure does not occur, that is, a gap remains. But such signs do not appear immediately. At first, the patient will only feel numbness in the ear area, and only then, after a day or two, paresis develops. Also, the pathological process is accompanied by loss of taste on the tongue on the side that is affected, dry mouth or, conversely, drooling, decreased hearing or, conversely, its aggravation, dry eyes or lacrimation.

Facial nerve paresis: diagnosis

To make a correct diagnosis, you will need to be examined by a therapist, neurologist and otolaryngologist. The main doctor in this case is a neurologist, and he will prescribe the necessary treatment. An examination by an otolaryngologist is necessary to exclude the possibility that the existing condition is a complication of pathology of the throat, nose or ear. The therapist gives an opinion on the general health of the patient. To determine the degree of paresis, electroneuromyography is performed. In addition, the nature of the pathological process is revealed.

Facial nerve paresis: treatment

It should be said that therapy must be started as quickly as possible, otherwise there is a risk of permanent paralysis. Also, treatment may be ineffective if the nature of the paresis is traumatic or otogenic. For treatment, vasodilators, anti-inflammatory and decongestant drugs, and antispasmodics are used. If there is pain, analgesics are additionally prescribed. Subsequent therapy is aimed at regenerating the affected nerve fibers and preventing muscle atrophy. For this purpose, physiotherapy and drugs that improve metabolism are prescribed. If conservative therapy is powerless, they resort to surgical intervention, during which the nerve is sutured, its plastic surgery is performed, and in case of tightening, the facial muscles are corrected.

Facial nerve paresis: symptoms and treatment

Facial nerve paresis - main symptoms:

• Pain behind the ear
• Loss of taste
• Tearing
• Drooping of the upper eyelid
• Open mouth
• Inability to completely close eyelids
• Drooping corner of the mouth
• Inability to stretch lips into a tube
• Unnaturally wide eye
• Smoothing the nasolabial fold
• Smoothing forehead wrinkles
• Inability to wrinkle forehead
• Hearing enhancement

Facial nerve paresis is a disease of the nervous system characterized by impaired functioning of the facial muscles. As a rule, a unilateral lesion is observed, but total paresis is not excluded. The pathogenesis of the disease is based on a disruption in the transmission of nerve impulses due to trauma to the trigeminal nerve. The main symptom indicating the progression of facial nerve paresis is facial asymmetry or the complete absence of motor activity of muscle structures from the localization of the lesion.

The most common cause of paresis is an infectious disease that affects the upper airways. But in fact, there are much more reasons that can provoke nerve paresis. This pathology can be eliminated if you contact a medical facility in a timely manner and undergo a full course of treatment, including drug therapy, massage, and physiotherapy.

Facial nerve paresis is a disease that is not uncommon. Medical statistics are such that it is diagnosed in approximately 20 people out of 100 thousand people. More often it progresses in people over 40 years of age. Pathology has no restrictions regarding gender. It affects both men and women with equal frequency. Trigeminal nerve palsy is often detected in newborns.

The main task of the trigeminal nerve is to innervate the muscle structures of the face. If it is injured, nerve impulses cannot fully travel along the nerve fiber. As a result, muscle structures weaken and cannot fully perform their functions. The trigeminal nerve also innervates the lacrimal and salivary glands, sensory fibers of the epidermis on the face and taste buds located on the surface of the tongue. If the nerve fiber is damaged, all of these elements cease to function normally.

Etiology

Paresis of the facial nerve can act in two qualities - an independent nosological unit, and a symptom of a pathology already progressing in the human body. The reasons for the progression of the disease are different, therefore, based on them, it is classified into:

• idiopathic lesion;
• secondary damage (progressing due to trauma or inflammation).

The most common cause of nerve fiber paresis in the facial area is severe hypothermia of the head and parotid area. But the following reasons can also provoke the disease:

• polio;
• pathogenic activity of the herpes virus;
• mumps;
• respiratory pathologies of the upper airways;
• head injuries of varying severity;
• damage to the nerve fiber due to otitis media;
• damage to the nerve fiber during surgery in the facial area;
• syphilis;
• tuberculosis.

Another reason that can provoke paresis is a violation of blood circulation in the facial area. This is often observed with the following ailments:

The trigeminal nerve is often damaged during various dental procedures. For example, tooth extraction, root apex resection, opening of abscesses, root canal treatment.

Varieties

Clinicians distinguish three types of trigeminal nerve paresis:

• peripheral. This is the type that is diagnosed most often. It can manifest itself in both an adult and a child. The first symptom of peripheral paresis is severe pain behind the ears. As a rule, it appears on one side of the head. If you palpate the muscle structures at this time, you can identify their weakness. The peripheral form of the disease is usually a consequence of the progression of inflammatory processes that provoke swelling of the nerve fiber. As a result, nerve impulses sent by the brain cannot fully pass through the face. In the medical literature, peripheral paralysis is also called Bell's palsy;
• central. This form of the disease is diagnosed somewhat less frequently than the peripheral one. It is very severe and difficult to treat. It can develop in both adults and children. With central paresis, atrophy of the muscle structures on the face is observed, as a result of which everything that is localized below the nose sags. The pathological process does not affect the forehead and visual apparatus. It is noteworthy that as a result of this the patient does not lose his ability to distinguish taste. During palpation, it can be noted that the muscles are under strong tension. Central paresis does not always manifest itself unilaterally. Bilateral damage is also possible. The main reason for the progression of the disease is damage to neurons located in the brain;
• congenital. Trigeminal nerve palsy in newborns is rarely diagnosed. If the pathology is mild or moderate in severity, then doctors prescribe massage and gymnastics for the child. Massage of the facial area will help normalize the functioning of the affected nerve fiber, and also normalize blood circulation in this area. In severe cases, massage is not an effective treatment method, so doctors resort to surgical intervention. Only this method of treatment will restore innervation to the facial area.

Degrees

Doctors divide the severity of trigeminal nerve paresis into three degrees:

• light. In this case, the symptoms are mild. A slight distortion of the mouth may occur on the side where the lesion is localized. A sick person must make an effort to frown or close his eyes;
• average. A characteristic symptom is lagophthalmos. A person can practically not move the muscles in the upper part of the face. If you ask him to move his lips or puff out his cheeks, he will not be able to do this;
• heavy. The asymmetry of the face is very pronounced. Characteristic symptoms are that the mouth is severely distorted, the eye on the affected side practically cannot close.

Symptoms

The severity of symptoms directly depends on the type of lesion, as well as on the severity of the pathological process:

• smoothing the nasolabial fold;
• drooping corner of the mouth;
• the eye on the affected side may be unnaturally wide open. Lagophthalmos is also observed;
• water and food flows out of the slightly open half of the mouth;
• a sick person cannot wrinkle his forehead much;
• a characteristic symptom is deterioration or complete loss of taste;
• auditory function may become somewhat worse in the first few days of pathology progression. This causes great discomfort to the patient;
• lacrimation. This symptom manifests itself especially clearly during meals;
• the patient cannot pull the lip into a “tube”;
• pain syndrome localized behind the ear.

Diagnostics

A doctor’s pathology clinic usually leaves no doubt that the patient’s trigeminal nerve paresis is progressing. In order to exclude pathologies of the ENT organs, the patient may additionally be referred for a consultation with an otolaryngologist. If the cause of such symptoms cannot be clarified, then the following diagnostic techniques may be additionally prescribed:

Therapeutic measures

This disease must be treated as soon as the diagnosis has been made. Timely and complete treatment is the key to restoring the functioning of the nerve fibers of the facial area. If the disease is neglected, the consequences can be disastrous.

Treatment of paresis should only be comprehensive and include:

• eliminating the factor that provoked the disease;
• drug treatment;
• physiotherapeutic procedures;
• massage;
• surgical intervention (in severe cases).

Drug treatment of paresis involves the use of the following pharmaceuticals:

• analgesics;
• decongestants;
• vitamin and mineral complexes;
• corticosteroids. Prescribe with caution if the pathology progresses in the child;
• vasodilators;
• artificial tears;
• sedatives.

Massage for paresis is prescribed to everyone - from newborns to adults. This method of treatment produces the most positive results in cases of mild to moderate damage. Massage helps restore the functioning of muscle structures. Sessions are carried out a week after the onset of paresis progression. It is worth considering that massage has specific features, so it should only be entrusted to a highly qualified specialist.

• warming up the neck muscles - you should bend your head;
• massage begins with the neck and back of the head;
• You should massage not only the sore side, but also the healthy one;
• an important condition for a quality massage is that all movements should be carried out along the lines of lymph outflow;
• if the muscle structures are very painful, then the massage should be superficial and light;
• It is not recommended to massage the locations of the lymph nodes.

Pathology should be treated only in a hospital setting. Only in this way will doctors have the opportunity to monitor the patient’s condition and observe if there are positive dynamics from the chosen treatment tactics. If necessary, the treatment plan can be adjusted.

Some people prefer traditional medicine, but it is not recommended to treat paresis in this way alone. They can be used as an adjunct to primary therapy, but not as individual therapy. Otherwise, the consequences of such treatment can be disastrous.

Complications

In case of untimely or incomplete therapy, the consequences may be as follows:

• irreversible damage to the nerve fiber;
• improper nerve restoration;
• complete or partial blindness.

If you think that you have Facial Nerve Paresis and the symptoms characteristic of this disease, then doctors can help you: a neurologist, an otorhinolaryngologist.

We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.

Facial nerve paresis is a fairly common disease. According to medical statistics, 20 out of 100 people receive this diagnosis. As a rule, people who have crossed the 40-year mark fall into the risk zone. However, a congenital complication also occurs. The pathology affects both men and women equally. In the early stages, the disease can be successfully treated, but in advanced stages, surgical intervention is required.

Facial neuritis, what is it?

Paresis or neuritis of the facial nerve (ICD code 10) is a disease of the nervous system that affects the facial muscles. Usually, one side is sick, but in exceptional cases a total disease occurs. The main symptom of facial neuritis is the lack of motor activity of the muscles. What causes facial asymmetry and worsens appearance. The disease can be quickly treated if a person promptly seeks medical help and completes the full course of therapy.

The disease appears due to disruption of the trigeminal nerve. It is responsible for facial movements. If it is injured, then the impulse is not able to fully transmit the signal to the fibers. Due to such a malfunction, the muscular system weakens and they cannot work properly. The trigeminal nerve promotes the secretion of saliva and tears, and it also stimulates the taste buds on the tongue. If the functioning of the nerve is disrupted, then these functions are not performed fully.

The disease is quite serious, since changes in appearance affect a person’s emotional state. At the first symptoms, it is important to consult a doctor. Doctors distinguish several types of illness. They all differ in the area of ​​damage to the facial muscles.

1. Peripheral paresis. All people are at risk. Neuritis begins with a nagging pain behind the ear. Only one side is affected. Paresis of the facial nerve of the peripheral type occurs due to various inflammations that impair the functioning of nerve impulses. As a result, the impulses transmitted by the brain cannot fully pass to the face.
2. Central paresis. This is a more complex disease that is difficult to treat. It is diagnosed in both adults and children. With paralysis, the muscles located below the nose atrophy and simply sag. The pathology does not affect the upper area of ​​the face, and does not affect the forehead and eyes. The patient, as before, can perfectly distinguish the taste of food. Typically, central facial palsy affects both sides of the face. The main cause of the disease is a malfunction of neurons located in the brain.
3. Congenital paresis. Diagnosed in newborns. Paresis of the facial nerve in newborns is visually noticeable, since one corner of the eye is slightly lowered to the bottom. Timely diagnosis allows you to quickly restore the baby’s health. As a rule, massage and special gymnastics are prescribed. The procedures help normalize blood flow and restore the functionality of nerve fibers. Sometimes a severe form of paralysis occurs. Then doctors recommend only surgery.

There are many causes of facial paralysis. However, the root cause is hypothermia of the head and ears. But the following problems can also provoke the disease:

• kidney disease (polymyelitis);
• herpes;
• infectious diseases of the respiratory tract;
• various head injuries;
• otitis;
• disruption of nerve endings during surgery;
• syphilis;
• tuberculosis.

Important! Facial paralysis often occurs as a complication after a stroke, hypertensive crisis, multiple sclerosis and in severe stages of diabetes. This nerve can be disrupted during dental procedures.

Signs of facial paralysis

The disease affects the facial nerve impulses, so they stop functioning normally. Because of this, the work of facial wrinkles is disrupted, which dulls movements. Paralysis does not change a person's appearance for the better. The changes depend on its type.

Among the main symptoms, doctors identify:

• drooping mouth corners;
• immobility of the fold above the upper lip;
• the eyelid is wide open, and when closed there remains a narrow gap;
• taste receptors on the tongue decrease or are completely absent;
• normal functioning of the eye is disrupted (tearing or dryness);
• there is no way to stretch the lips, which makes it difficult to eat normally;
• For the first time in a few days, pain in the ears appears with loud sounds;
• I can’t wrinkle my forehead, my skin remains smooth.

All these symptoms are quite unpleasant, so you need to seek medical help.

Degrees of facial nerve paresis

Paralysis is divided into several degrees of complexity. They all differ in the severity of the disease:

• 1st degree (mild). Signs of the disease are mild. There may be a slight distortion of the corner of the mouth, it is difficult to frown and close the eyes;
• 2nd degree (medium). The main symptom is lagophthalmos. The patient cannot move the upper part of the face;
• 3rd degree (severe). All symptoms are quite pronounced. The patient's eyes cannot close, the mouth is distorted and the movement of facial wrinkles is difficult.

Important! In the early stages, paresis responds quite well to treatment. For this purpose, special procedures and medications are prescribed.

Diagnostics

Clinical symptoms of facial paralysis, experienced doctors do not raise any doubts about the accuracy of the diagnosis. Additionally, an appointment is made to visit an ENT doctor. To accurately establish the cause of the disease and exclude a tumor, the patient is prescribed an instrumental examination:

• head scan.

Based on the data obtained, the doctor can find out the reason that provoked this complication and begin treatment.

Treatment of the disease directly depends on the time at which the patient consulted a specialist. Recovery takes at least 6 months. During this time, the patient undergoes a course of drug therapy and physiotherapy, he receives a massage and performs special gymnastics.

Drug therapy

In acute form, the doctor must determine the cause of the pathology, remove swelling and inflammation. Additionally, medications are prescribed that restore cells and stimulate muscle function. Among the main medications, the patient is prescribed:

• painkillers, in tablets or injections (Baralgin, Spazgan, Ketorol);
• relieving edema (Traimpul, Furosemide, Prednisolone);
• sedative sedatives (Sibazon, Relanium);
• B vitamins;
• drops of artificial tears.

As a rule, if additional symptoms are present, a person is prescribed certain medications. All medications are prescribed only by a doctor. They must be taken according to the prescribed dosage. Before treatment, it is important to read the instructions.

Surgical treatment

Surgery is recommended for severed nerves, serious injuries, and congenital defects. This treatment is effective if it is carried out in 1 year of the disease. If this is not done, then over time the nerve will atrophy and will never be able to move the muscles.

In case of rupture, the nerve is simply sutured. If another cause is established, then autotransplantation is recommended. The graft is taken from the person's leg and placed on the desired area of ​​the face. After which the nerve endings are attached to it. As a rule, the operation is always successful and the person’s facial movements are restored. After the procedure, a small scar remains behind the ear.

At the initial stages of the disease, the patient is prescribed physical therapy. As treatment changes occur, these procedures may be changed or eliminated entirely. As a rule, the patient is prescribed:

• paraffin therapy;
• phonophoresis with special preparations;
• Sollux lamp.

Gymnastic exercises

Gymnastics for facial nerve paresis is prescribed to absolutely everyone. In the early stages, it gives excellent results and quickly restores muscles. The exercise technique is simple, it includes the following movements:

• raise and lower eyebrows;
• puff out your cheeks and press on them with your hands;
• make the lips into a tube and pull them forward;
• They open their eyes one by one, and then close their eyes tightly.

Simple exercises can be performed in your free time at home.

Massage for facial paresis 99

The procedure should only be performed by a specialist, as it is important to be meticulous and feel the patient’s muscles. The massage technique includes the following actions:

• warming up the neck muscles by bending to the sides;
• knead the neck and back of the head with light movements;
• massage both the sick and healthy side;
• in case of severe pain, all movements should be smooth and easy;
• lymph nodes are not massaged.

Folk remedies

It is necessary to supplement the main treatment with folk remedies. To calm the nervous system, you need to drink tinctures and teas based on herbs (mint, lemon balm, motherwort, thyme, hawthorn). The affected side must be warmed. To do this, heat the salt, place it in a fabric bag and apply it to the sore spot. Rubbing fir oil warms up pinched muscles well.

Complications arise if a person does not consult a doctor in a timely manner or is negligent in following recommendations. The consequences are quite serious, including blindness and irreversible nerve damage.

Treatment of facial paralysis represents a difficult problem for both the doctor and the patient. This potentially disabling disease can have many causes, so a detailed understanding of the differential diagnosis and available treatments is necessary to select the correct management.

For optimal cosmetic and functional results all patients with facial paralysis treatment should be provided taking into account the individual characteristics of the disease with the participation of a team of various specialists.

Frequency of occurrence facial paralysis depends on its etiology. More detailed information is provided in the following articles on the site - we recommend using the search form on the main page of the site.

A) Classification of facial paralysis. A reliable method for assessing facial nerve function is the House-Brackmann scale. It is not applicable to patients with facial synkinesis. Other scales have also been proposed that assess the degree to which paralysis affects the physical and mental state of the patient.

b) Anatomy of the facial nerve. The facial nerve enters the temporal bone through the internal auditory canal and then follows the bony fallopian canal. Most often, compression and paralysis of the nerve due to various inflammatory processes occur in this segment of the nerve. After emerging from the stylomastoid foramen, the facial nerve passes through the parenchyma of the parotid salivary gland, so in the preauricular region the nerve is protected by gland tissue.

Then, within its thickness, the facial nerve divides into five main branches, which leave the gland deeper from the superficial muscular aponeurotic system (SMAS). Anterior to the parotid salivary gland, the distal branches of the nerve communicate with each other, so here the fibers of the facial muscles can be innervated by several nerves at once.

Educational video of the anatomy of the facial nerve and the projection of its branches

If you have problems watching, download the video from the page

V) Congenital causes of facial paralysis:

1. Birth trauma. During childbirth, several factors can contribute to injury to the facial nerve with subsequent paralysis. These include the use of obstetric forceps, birth weight more than 3.5 kg, first pregnancy. The provoking factor is compression of the fetus as it passes through the birth canal. Under these conditions, the facial nerve is extremely susceptible to injury due to stretching, and it takes time to restore normal function.

In general, the prognosis is extremely favorable; 90% of children experience complete restoration of facial nerve function without any surgical or pharmacological interventions. In rare cases where there is a high risk of nerve rupture, surgical exploration may be required.

2. Mobius syndrome. Moebius syndrome, first described in the 19th century, is characterized by combined paralysis of the facial and abducens nerves, which may be caused by underdevelopment of the peripheral part of the nerves or insufficient functioning of the nuclei of the brain stem. Sometimes other cranial nerves are affected. Clinically, there is a violation of the mobility of facial muscles; it is difficult for patients to display any emotions on their faces.

Other symptoms and signs include incomplete lip closure, drooling, decreased self-esteem, and social isolation. All these factors aggravate the general condition. In patients with this syndrome, free muscle tissue transplantation is successfully used to restore the function of facial muscles. It is highly advisable to carry out surgical treatment before starting school in order to prevent the psychological trauma that a child may receive due to insults from peers at a very early stage in his life.

3. Melkersson-Rosenthal syndrome. Melkersson-Rosenthal syndrome is characterized by a triad of recurrent facial nerve paresis, facial swelling, and folded tongue. In the treatment of exacerbations, glucocorticosteroids and anti-inflammatory drugs are used. There is no consensus on how to treat and prevent facial paresis. Some descriptions of individual cases provide information about decompression of the facial nerve (opening the bony walls of its canal to prevent compression of the nerve as swelling increases), according to which the long-term prognosis for restoration of nerve function turns out to be more favorable when using such a fairly aggressive treatment tactic.

4. Hemifacial microsomia. The group of hemifacial microsomia includes a number of congenital developmental anomalies, which are based on underdevelopment of one half of the face. The syndrome is characterized by a deficiency of soft tissue on one side of the face, underdevelopment of the lower and upper jaws, and the external ear. In the presence of combined facial nerve paresis, surgery for it can be performed simultaneously with craniofacial reconstruction of the jaws and ear. Particularly useful in restoring facial symmetry and the patient's ability to smile is the use of free muscle grafts, one of the additional effects of which is to add volume to the facial area.

Course of the prepared facial nerve.
Temporal part: 1 - meatal segment; 2 - labyrinth segment; 3 - drum segment; 4 - mastoid segment.
Extratemporal part: 5 - temporal branches; 6 - zygomatic branches; 7 - temporofacial portion;
8 - buccal branches; 9 - cervical branches; 10 - marginal mandibular branch; 11 - neck part; 14 - extratemporal part.
Other structures: 12 - duct of the parotid gland; 13 - parotid gland.

G) Infectious causes of facial paralysis:

1. Bell's palsy. Bell's palsy is also known as idiopathic facial palsy. However, recent evidence suggests that most cases of Bell's palsy are caused by the herpes simplex virus. The incidence is about 30 cases per 100,000 people. Paralysis usually develops within 24-72 hours. It may be accompanied by pain around the ear, decreased taste, and decreased hearing on the affected side. And although in the vast majority of patients, nerve function gradually returns to normal, some of them continue to have limited mobility of the facial muscles, which is often combined with periodic aberrant twitching (syncinesia).

In the acute phase of the disease, glucocorticosteroids and antiviral drugs can be successfully used to improve the recovery of nerve function. In some cases where the electrical activity of the nerve is significantly reduced during the first two weeks (see examination section below), surgical decompression of the facial nerve canal should be considered. If restoration of nerve function has not occurred and synkinesis persists, a rehabilitation option that has a chance of success is chemical denervation of the nerve (paralysis) using botulinum toxin A followed by an intensive course of physical therapy.

2. Hunt syndrome. Hunt's syndrome (herpes zoster oticum) occurs when the Varicella zoster virus (human herpes virus 3) is reactivated in the area of ​​the facial nerve. Other symptoms include ear pain and the formation of vesicles (zoster oticus). Other symptoms may also occur: hearing loss, tinnitus, dizziness, nausea and vomiting, which are believed to arise from irritation of the vestibulocochlear nerve, located near the facial nerve in the thickness of the temporal bone. Although there are no randomized controlled trials evaluating the effectiveness of different treatment methods for this rare pathology, a combination of corticosteroids, antivirals and analgesics can be successfully used to suppress inflammation of the facial nerve.

This treatment regimen is based on experience with the treatment of facial paralysis (corticosteroids), as well as Herpes zoster lesions in other parts of the body (which are treated with antiviral drugs). In Hunt syndrome, the prognosis for restoration of facial nerve function is poor. After the infection has resolved, patients often continue to experience chronic neuralgia (pain).

3. Otitis media and mastoiditis. Otitis media and mastoiditis are acute inflammation of the mastoid process, which in rare cases (less than 1%) can lead to facial paralysis. It is believed that nerve damage is caused by swelling of the surrounding tissue and exposure to bacterial toxins. Successful treatment consists of timely recognition and eradication of the infection, which includes the use of broad-spectrum antibiotics and myringotomy with the installation of a ventilation tube to obtain material for culture. In some cases of mastoiditis, mastoidectomy (removal of the affected mastoid tissue) is indicated. If all of the above measures are performed, the prognosis for restoration of nerve function is favorable.

4. Cholesteatoma. Cholesteatoma is a slowly growing cystic formation of epithelial origin, which over time causes destruction of surrounding tissues with their compression and the appearance of foci of chronic inflammation. The incidence of facial paralysis with cholesteatoma reaches 3%. Timely diagnosis and surgical removal of cholesteatoma are necessary to successfully eliminate compression of the facial nerve that develops against the background of chronic inflammation and infection. Unfavorable prognostic signs include the spread of cholesteatoma to the apex of the pyramid (deep part of the temporal bone) and untimely surgical treatment. Patients who receive early surgical treatment are most likely to regain facial nerve function.

5. Lyme disease. Lyme disease is caused by the pathogen Borrelia burgdorferi, which enters the human body through the bite of a tick infected with the microorganism. Typical symptoms and signs of the acute stage of the disease include headache, weakness, fever and erythema chronicum migrans (a characteristic skin rash that occurs at the site of a tick bite). And although concomitant damage to the facial nerve can occur in 11% of cases, its function is completely restored in 99.2% of patients. Lyme disease should always be kept in mind when treating patients living in endemic areas who develop symptoms after tick bites in the summer. On the website of the US Centers for Disease Control and Prevention you can find a map that shows the frequency of occurrence of the disease in different US states. To confirm the diagnosis and begin antibacterial therapy, determination of antibody levels is required. Treatment is carried out in accordance with the recommendations of the Infectious Diseases Society of the United States.

6. Other. A number of other infectious diseases can manifest as dysfunction of the facial nerve. These include HIV infection, tuberculosis, infectious mononucleosis and others. In most cases, these diseases are accompanied by a number of other symptoms; for a correct diagnosis, the doctor must be extremely alert. When carrying out differential diagnosis, it is necessary to take into account the patient’s medical history and the presence of relevant risk factors. The basis of treatment is correctly selected pharmacotherapy, except in cases where mastoiditis is detected as a result of additional examination. In this case, a mastoidectomy is performed to eradicate the infection and reduce swelling around the nerve.

d) Systemic and neurological causes of facial paralysis. These include autoimmune diseases, diabetes, sarcoidosis, Guillain-Barre syndrome, multiple sclerosis and others. In rare cases, these diseases manifest as isolated facial paralysis. In most cases, with timely diagnosis and prompt initiation of adequate treatment, it is possible to restore nerve function.

e) Traumatic causes of facial paralysis. Head and skull injuries are one of the most common causes of acquired facial paralysis. If the injury was blunt and there are no fractures or soft tissue injuries, the integrity of the facial nerve is preserved and its function is likely to be restored. If nerve damage is suspected (penetrating injury to the skin and soft tissues of the face), immediate surgical revision of the wound is required to restore the integrity of the nerve. Under ideal conditions, surgery should be performed within three hours of injury while the distal fragment can be stimulated to allow identification of the nerve during surgery.

At combination of facial skeleton trauma With a fracture of the temporal bone, damage to the facial nerve occurs in 10-25% of cases. Depending on the relationship of the fracture line to the longitudinal axis of the temporal bone, the following types of fracture are distinguished: longitudinal (80%), transverse (10%) and mixed (10%). Facial nerve paralysis is more often observed with transverse (50%) fractures rather than longitudinal (20%). Complete restoration of nerve function is most often observed with delayed development. On the contrary, in 50% of cases of acute paralysis, recovery is extremely poor. Often, due to existing extensive injuries to the facial area and other emergency conditions, diagnosis and assessment of facial nerve function is not carried out in a timely manner. However, delayed surgery, which can be performed even several months after the injury, still has a reasonable chance of restoring or improving the function of the facial muscles.

Iatrogenic facial nerve damage may occur during operations on facial tissues, the skull, or during intracranial interventions. The choice of treatment method depends on the extent of nerve damage. In severe cases, restoring the integrity of the nerve is impossible, which is why it is necessary to resort to other methods.

e) Tumors as a cause of facial paralysis. Removal of tumors that penetrate the facial nerve or are located in close proximity to it often requires significant exposure to the nerve, which may result in its partial or complete transection. The most common tumors affecting the facial nerve include acoustic neuroma (vestibular schwannoma), glomus tumors, facial neuroma, and parotid cancer. If during the operation the integrity of the facial nerve was preserved, careful monitoring of its condition is required in the postoperative period. To clarify the prognosis, electrical stimulation of the nerve can be performed at the end of the operation. Corticosteroids are not usually used in this situation because several studies have clearly shown their lack of effectiveness in this setting. After surgery, electromyography (EMG) can be used to assess the process of reinnervation of the facial muscles.

Depending from the recovery stage(as well as individual patient preferences and difficulties), several simple techniques can be used to ensure eyelid closure, facial asymmetry, and complete lip closure.

and) Possible complications. If the integrity of the facial nerve has been successfully restored (or was not damaged initially), resolution of the paralysis depends on the regeneration of axons and their growth into the facial muscles. With pathological regeneration, there may be a change in the direction of the axons, or their branching to many fibers at once. As a result of this process, synkinesis occurs, which are involuntary twitches of facial muscles during their contraction.
Other possible complications of facial paralysis include severe dryness of the eyeball with subsequent keratopathy, incomplete closure of the lips with saliva, and constant cheek biting.

Doctors call facial paralysis with a complex word “ prosopoplegia" With this condition, paralysis of the facial muscles develops.

Why does this condition develop and is it treatable?

If you want to learn more about facial paralysis, read this article and the medical board of tiensmed.ru (www.tiensmed.ru) will try to tell you about it.

The symptoms of facial paralysis are quite obvious. The victim may not wrinkle his forehead, or one eye may not close, and one corner of his mouth may hang down.

All these unfortunate manifestations of facial paralysis come from damage to the facial nerve. How can this nerve be damaged?

Yes, very simple. You can wash your face with ice water from a well or tap in the morning and get facial paralysis. See how simple it is. You can also work in a draft - half of your head is blown through - and that’s paralysis of your face. In addition, the cause of facial paralysis can be self-poisoning of the body due to diabetes mellitus. Very often, facial paralysis is a consequence of a stroke. Facial paralysis can also develop as a result of an injury in the temple area.

As easy as it is to get facial paralysis, it is also easy to prevent it. If you at least wear a hat when walking or working in a cold room, the risk of inflammation of the facial nerve will be significantly reduced.

In cases of hypothermia, facial paralysis affects only one part of the face. At first you will feel pain and increased body temperature. After all, inflammation of the facial nerve is an inflammatory process that occurs with all its classic signs. Such paralysis can also affect the nerve endings responsible for the activity of the salivary glands and lacrimal glands. Therefore, the patient may have tears flowing from one eye and saliva from the mouth. In addition, hearing on the damaged side may also deteriorate.

If facial paralysis is caused by a stroke, then it manifests itself somewhat differently. The patient has one corner of his mouth drooping and the fold running from the wing of the nose to the corner of the mouth disappears. Most often, the upper part of the face is not affected by a stroke. Quite often, facial paralysis during a stroke is accompanied by paralysis of the limbs on this side of the body. Almost

Eighty percent of stroke patients suffer from similar symptoms to a greater or lesser extent.

If the stroke affects the brain stem. then facial paralysis is very strong. The patient has no sensitivity of the skin. Such paralysis is very dangerous because it can also affect those areas of the brain that regulate the functioning of the lungs and heart. If such paralysis develops, urgently take care of hospitalization of the patient.

With a stroke, paralysis of the muscles that move the eyelid often develops. In such a patient, one eyelid stops moving completely or partially. This phenomenon is called ptosis. The eyelid stops moving exactly on the side on which there was hemorrhage. But the limbs are paralyzed on the other side of the body.

For facial paralysis of any origin, it is very important to do special gymnastics. If you can at least slightly control the facial expressions of the affected parts of the face, then you need to do this. If the movements do not work out at all, then it is necessary to imitate passive gymnastics, moving the necessary areas with your hands. To do this, you need to place your finger on the place that should move and slowly try to repeat the movement of this area. The duration of the gymnastics is ten to fifteen minutes in the morning and evening.

In addition to gymnastics, you should definitely take a course of special massage. During the massage, both parts of the face are worked out: both the sick and the healthy ones equally. You should not contact home-grown specialists for massage. They will not be able to properly work the muscles and will only waste your time. Find a qualified massage therapist.

During treatment and rehabilitation after facial paralysis, take vitamin and mineral dietary supplements (dietary supplements) to maintain the body.

Before use, you should consult a specialist.

Facial neuritis: treatment, symptoms, causes

Facial neuritis is an inflammation of the VII cranial nerve, leading to disruption or loss of its function.

The facial nerve is the VII pair of cranial nerves; it innervates the facial muscles. As a rule, neuritis occurs on one side. In this case, paralysis of the facial muscles on one side is observed.

The facial nerve passes in its own canal in the skull; when an inflammatory process occurs, swelling appears; if the canal of the facial nerve is narrow, the nerve is pinched there, which leads to disruption of its blood supply, therefore, the dysfunction increases.

Causes of neuritis of the facial nerve

In most cases, the specific cause of facial neuritis cannot be determined. Doctors identify only probable provoking factors.

Trigger factors include:

• Local hypothermia. Sometimes it may be enough to sit under the air conditioner or drive a car with the window open.
• Previous infectious disease, for example, acute respiratory viral infection.
• Chronic inflammatory processes of the ENT organs, for example, otitis media, mesotympanitis. Also, the occurrence of facial neuritis can be facilitated by operations performed for purulent lesions of these organs.
• Trauma (crack or fracture) to the jaw or base of the skull.
• Systemic diseases, metabolic disorders. There is a decrease in the body's reactivity, in this case the immune system may not be able to cope with even mild inflammation.

Classification of facial neuritis

Primary neuritis is distinguished; it occurs as a result of hypothermia, for example. Secondary is also isolated; it occurs as a result of existing inflammation, for example, with otitis media. Separately, some forms of facial neuritis should be noted.

• Hunt's syndrome - facial neuritis in herpes zoster

Damage to the facial nerve is combined with other manifestations of this disease, such as characteristic rashes on the tongue, mucous membrane of the oral cavity and pharynx, as well as in the area of ​​the auricle (see symptoms and treatment of herpes zoster). In this case, the herpes virus affects the ganglion, from which the hearing aid, tonsils and palate receive innervation. The motor branches of the facial nerve are located close to this ganglion. The disease begins with shooting pains in the ear area, followed by facial asymmetry, decreased taste sensitivity in the anterior third of the tongue, dizziness, ringing in the ears and horizontal nystagmus.

• Neuritis due to mumps (mumps)

Can be one-sided or two-sided. Accompanied by fever, signs of intoxication and enlargement of the parotid salivary glands.

• Neuritis due to borreliosis

Bilateral damage to the facial nerve is always observed. Accompanied by a rise in temperature, erythema and widespread neurological symptoms.

• Neuritis with otitis media

Symptoms of neuritis of the facial nerve in this case are accompanied by pain in the ear area, which is acute. An infection from the middle ear contacts the branches of the facial nerve.

• Melkerson-Rosenthal syndrome

This is a hereditary disease, which is quite rare, and is characterized by a paroxysmal course. During an exacerbation, swelling of the face, neuritis of the facial nerve and folding of the tongue are observed.

Clinical picture of the disease - symptoms of neuritis

1 smooth forehead

2 impossible to close the eyelid

3. drooping corner of the mouth

4. facial nerves

Facial neuritis develops slowly.

• At first, only pain behind the ear may appear.
• After a few days, facial asymmetry appears. In this case, there is a smoothing of the nasolabial fold on the affected side, and drooping of the corner of the mouth.
• Also, the patient cannot close the eyelids on the same side, and when trying to do this, Bell’s symptom appears - the eyeball turns upward.
• The patient cannot bare his teeth, smile, raise his eyebrows, close his eyes, or make his lips appear like a tube.
• On the affected side, the eyelids are wide open, the eyeball seems to be pushed forward (lagophthalmos). The symptom of a “hare’s eye” is always present - a white strip of sclera is visible between the iris and the lower eyelid.

Since the facial nerve has several bundles that provide sensory innervation, the following symptoms may occur:

• loss of taste sensitivity in the anterior third of the tongue
• salivation
• dry eye or, conversely, lacrimation
• Some patients exhibit an interesting feature. Dry eyes cause tearing when eating
• A number of patients experience hyperacusis - ordinary sounds seem loud and too harsh to them

Diagnosis of facial neuritis

As a rule, the clinical picture of the disease allows an immediate, unmistakable diagnosis to be made. Additionally, electromyography, evoked potentials, or magnetic resonance imaging may be prescribed to identify the underlying disease that could cause the development of facial neuritis (tumor, inflammatory process).

During a neurological examination, the patient is asked:

• close your eyes
• raise your eyebrows
• smile or bare teeth
• and also depict blowing out a candle

With all these tests, facial asymmetry and the inability to fully perform these actions are observed. Sensitivity in the anterior third of the tongue is also examined by tingling this area. Observe whether there is tearing or dryness of the eye, which helps determine the level of nerve damage.

Treatment methods for facial neuritis

There are several important points regarding how to treat facial neuritis. If it is determined that secondary facial neuritis occurs, treatment begins with the underlying disease that caused the pathology of the facial nerves.

Treatment of neuritis is not limited to drugs; many other auxiliary methods are used, including physiotherapy, massage, gymnastics, acupuncture and other non-drug methods.

Massage and self-massage

Massage for neuritis of the facial nerves can be performed by both a specialist and the patient himself. In the second case, you should know exactly how to do it. Below is a technique for performing self-massage for this disease.

• Place your hands on the areas of your face located in front of the ear. Massage and pull the muscles on the healthy half of the face down, and on the affected side – up.
• Close your eyes. Use your fingers to massage the orbicularis oculi muscle. On the healthy side, the movement should go from above, outwards and downwards, and on the affected side, from below up and from the inside outwards.
• Place your index fingers on both sides of your nose. On the healthy side, stroke from top to bottom, and on the affected side, vice versa.
• Use your fingers to smooth out the muscles in the area of ​​the corners of the lips. On the healthy side, from the nasolabial fold to the chin, and on the affected side, from the chin to the nasolabial fold.
• Massage the muscles above the eyebrows in different directions. On the healthy side to the bridge of the nose and down, on the affected side - to the bridge of the nose and up.

Acupuncture

With neuritis of the facial nerve, rehabilitation can be lengthy and a similar treatment method is often used to achieve the fastest possible effect.

Not all doctors are proficient in this method; only a specially trained doctor can perform acupuncture. In this case, sterile thin needles are inserted into certain reflexogenic points on the face, which allow irritation of the nerve fibers. According to numerous studies in Asia and European countries, this method has proven itself to be excellent in the treatment of this pathology.

Therapeutic gymnastics

Gymnastics for facial neuritis is done several times a day for 20-30 minutes. It should be done in front of a mirror, concentrating on the work of the facial muscles of the affected side. When performing exercises, it is necessary to hold the muscles on the healthy half of the face with your hand, since otherwise they can “pull” the entire load onto themselves.

A set of exercises for facial neuritis

• Close your eyes tightly for 10-15 seconds.
• Raise your upper eyelids and eyebrows up as much as possible and hold the position for a few seconds.
• Slowly frown your eyebrows and hold this position for a few seconds.
• Try to slowly inflate the wings of your nose.
• Slowly inhale air through your nose, while placing your fingers on the wings of your nose and pressing on them, resisting the air flow.
• Smile as widely as possible, try to make your molars visible when smiling.
• Smile widely with your mouth closed and lips closed, making the sound “i”.
• Place a small walnut behind the cheek on the affected side and try to talk like this.
• Puff out your cheeks and hold your breath for 15 seconds.
• Curl your tongue, cover your lips, and slowly inhale and exhale through your mouth.
• Move your tongue between your cheek and teeth in a circle.

Surgical treatment

If there is no effect within 10 months from the start of conservative treatment, then autotransplantation has to be done. Typically, a nerve is taken from the patient's leg and sutured to the branches of the facial nerve on the healthy side, and the other end is sutured to the muscles on the affected side. Thus, the resulting nerve impulse causes the facial muscles to contract on both sides simultaneously. This treatment method is carried out no later than one year from the onset of the disease. Later, irreversible atrophy of the facial muscles on the affected side occurs.

Treatment with folk remedies

Folk remedies for facial neuritis are not very effective and can lead to worsening of the condition and prolong the disease. Some people use chamomile decoction compresses, dry heat, or rubbing ointments with herbal extracts. All these methods are practically ineffective, so you need to consult a doctor for help.

Prognosis and prevention

In most cases, with adequate treatment, the disease is completely cured. In some cases, there may be consequences in the form of poor facial expressions on the affected side. If there is no effect of treatment after 3 months, the likelihood of complete recovery decreases sharply.

Prevention of the disease includes two main ways to prevent this disease:

• Avoid hypothermia and drafts
• Timely and adequate treatment of inflammatory processes in the ear and nasopharynx area

Treatment of facial paralysis with folk remedies

Treatment of facial paralysis with elderberries

The facial nerve communicates with arteries and nerve plexuses. Many nerve plexuses from the ear canal, temporal artery, oral cavity, back of the head, and so on go to the facial nerve. Often it is women who suffer from facial nerve disease in adulthood. This disease occurs suddenly. Just one day you may feel severe pain on the side of your face in the area of ​​the facial nerve. You can apply ice for the first time, the pain will subside, but in any case it will return to you again and again. And this pain will appear more and more often.

Japanese Shiatsu massage

Shiatsu massage is a good folk method for treating the facial nerve. It relieves heat and fatigue from facial nerves without having to buy or drink anything. There are eight points on the face and neck that should be rubbed with pieces of ice in order to remove heat from the main points of the nerve branches. Wear gloves before wiping ice on your face. Massage the points in order.

The first point is located above the eyebrow.

The second point is located above the eye.

The third point is located under the cheekbone.

The fourth point is where the wing of the nose is, on the edge.

The fifth point is between the lower lip and chin.

The sixth point is located at the temples.

The seventh is the point located in front of the ear.

And the last - the eighth point - on the neck, more precisely, on its back side

Massaging the neck on both sides of the spine, you need to go lower and make rotational movements with ice. At the last, eighth point, stop for ten seconds. And don’t forget that each point takes the same amount of time on average. After you have done the ice massage, you need to take off your gloves and touch the cooled points with warm hands. And then massage each point again with ice while wearing gloves for ten seconds. And warm up these points again. This needs to be done about three times - and then you will feel relief, since it is the sharp changes from cold to warmth that help get rid of pain.

- Inaccurate recipe? — write to us about it, we will definitely clarify it from the original source!

The facial muscles are innervated by the facial nerve; it is also connected by the intermediate nerve, which is responsible for the taste sensitivity of the anterior part of the tongue, the lacrimal gland and the stapedius muscle. The facial nerve gives a total of 14 branches. When it is affected, there is sudden weakness of the facial muscles. This phenomenon is called “facial nerve palsy.”

It is impossible to name the reasons with one hundred percent probability: we only know about the diseases during or after which the signs and risk factors appeared. Frequent damage to the facial nerve due to external influences is due to a narrow canal: the nerve occupies 40–70% of its cross-sectional area, without changes in thickness even in particularly narrowed areas. In some cases, the disease goes away on its own, in others it leaves consequences for life.

In 1821, an article by Charles Bell was published, who described a case of facial paresis. In subsequent works, he supplemented the symptoms of the disease and presented the anatomy and functions of the facial nerve. After some time in the medical world, the term "Bell's palsy" became common for this disorder. But the first person to describe this disease was Avicenna: he not only indicated the clinical symptoms, but also distinguished between peripheral and central paralysis.

Manifestations of paralysis

The symptoms are quite pronounced. These will include:

• weakening of facial muscles and smoothness of skin folds on one part of the face;
• mouth distortion;
• incomplete closure of the eyelid;
• swelling of the cheeks when pronouncing vowels;
• upward displacement of the eyeball when trying to close the eyes (Bell's symptom);
• change in diction;
• impaired salivation - saliva begins to leak from the corner of the lips;
• changes in auditory sensations (ringing in the ears, sensitivity to loud sounds, even pain), as well as hearing loss.
• in some cases – a change in taste sensations;
• ear pain due to damage to the tympanic branch.

Due to the fact that the eyeball of the affected side is not completely closed with the eyelid, it dries out (in this case, the localization of the lesion is located before the origin of the large superficial petrosal nerve). At the same time, the eye may constantly water (the lesion is localized in the place that precedes the exit of the stapedius nerve).

Most often, this disease is diagnosed in pregnant women and the elderly.

When people talk about this disease, they often mean its peripheral type (also known as Bell's palsy), since it occurs in most cases. But there is also central facial palsy (supranuclear), in which only the lower muscular part opposite the lesion is affected.

Its main symptoms:

• preservation of the muscles of the upper part of the face (the eye is not covered, the patient is able to wrinkle his forehead);
• consistency of taste sensations;
• sagging muscles of the lower facial part;
• partial paralysis of one half of the body (hemiparesis).

Central paralysis (paresis) often occurs as a consequence of a stroke and, unlike peripheral paralysis, can be bilateral.

Origin of the disease

Possible causes may include:

• cranial trauma;
• inflammation of the brain (meningitis, encephalitis);
• infection (herpes simplex, chickenpox and shingles, cytomegalovirus, ARVI and influenza, coxsackie, Epstein-Bar viruses);
• tick-borne borreliosis;
• neoplasms;
• metabolic and hormonal imbalance (diabetes mellitus, hypothyroidism, uremia, acute deficiency of B vitamins);
• stroke, atherosclerosis of cerebral vessels, hypertension;
• genetic predisposition;
• a congenital abnormality of the canal through which the nerve passes.

The doctor’s task is to find the disease that caused paralysis, since it may not be an independent illness, but a sign of a serious illness that requires immediate treatment. This applies, first of all, to the presence of tumors, stroke, borreliosis, and metabolic disorders. However, in 80% of cases the causes of the disease remain unknown.

Severity

When symptoms are moderate, they speak of paresis (partial paralysis). We list five forms that are distinguished according to the severity of the lesion.

1. The lung is characterized by slight muscle weakness, the ability to close the eye (but with effort), and subtle asymmetry of the mouth.
2. Moderate suggests obvious but not disfiguring asymmetry. At the same time, the eye also closes with effort.
3. In the moderate form, there is severe muscle weakness, and the asymmetry can be disfiguring. There is no movement of the forehead, the eye does not close completely.
4. Severe involves barely defined muscle movements.
5. Not a single movement is recorded with complete paralysis.

Complications and prognosis

Irreversible consequences of the disease can occur in approximately 30% of cases. There may be several of them.

1. Contracture, the symptoms of which are manifested in increased muscle tone of the affected side with pain and rhythmic twitching. The patient experiences a feeling of tightening of the face.
2. Synkinesis - conjugal muscle movements. For example, there may be a raising of the corner of the mouth or a wrinkling of the forehead when closing the eye and vice versa. This disorder occurs due to improper restoration of nerve fibers.
3. Partial or complete loss of vision in an eye that does not close completely.

But the percentage of complete recovery is approximately 50–60% - mainly due to the quality of medical care received; sometimes the disease recedes on its own. It is often impossible to predict relief from paralysis or the likelihood of possible consequences; doctors name only a few complicating factors that worsen the prognosis:

• severe degrees of paralysis;
• the appearance of contracture or synkinesis;
• damage to the eyeball of the affected side;
• presence of pain;
• prolonged treatment, in which there are no symptoms of improvement;
• old age;
• the presence of degenerative changes in the nerve according to the examination results;
• the presence of concomitant diseases (for example, diabetes).

Diagnosis and therapy

The doctor relies on visual symptoms of the disease, checks reflexes and refers to instrumental examinations, including electroneuromyography (ENMG) and tomography (MRI or CT). The latter is designed to detect the disease that acted as the cause.

ENMG allows you to assess the condition of muscles and nerve endings, measure the speed and number of impulses passing through the nerves, and determine the location of the lesion. During the procedure, stimulation is carried out using electronic impulses, the response to which is recorded by the device.

ENMG should be prescribed a week after the first symptoms were noted, since the affected trunk of the facial nerve continues to conduct impulses for another 5-6 days.

Possible treatments

Treatment of facial nerve paralysis involves the use of corticosteroids to relieve swelling and inflammation and restore microcirculation. These drugs form the basis of therapy - almost 80% of patients who received them experienced significant improvements in their condition. However, the use of corticosteroids in children is not justified; in most cases they were ineffective and caused side effects.

If it was known that paralysis was preceded by exacerbations of herpes simplex, the appearance of chickenpox and herpes zoster, acyclovir and its derivatives are used. In all cases, alpha lipoic acid and B vitamins are also prescribed to restore metabolism and damaged structures.

Use of botulinum toxin

If Bell's palsy is diagnosed, the doctor's special attention should be directed to the preservation of the eyeball of the affected side: in severe cases, the patient's eye does not close even during sleep. Eye drops and ointments can only be used to relieve symptoms (dryness and redness), but not to prevent keratopathy. Previously, in medical practice, eyelids were sewn together or implants were inserted into the upper eyelid to lower it. Currently, a common method is to administer botulinum toxin injections. The duration of the effect is 2-3 weeks - during this time recovery is possible. If treatment is delayed, repeated administration is used.

By the way, the use of such injections is possible not only to prevent eye loss, but also to improve the aesthetics of facial expression, partially restore functions and combat contractures and synkinesis. The administration of botulinum toxin has been practiced in medicine for more than 30 years to treat diseases that are accompanied by muscle spasms.

In Russia, Botox, Dysport, Lantox, and Xeomin are used. Given the opportunity to choose, doctors give preference to the latter, which is a new generation drug. The absence of hemagglutinating proteins in its composition allows one to avoid consequences.

Other ways

In severe cases, surgery may be indicated, but recently doctors are trying to avoid it due to the large number of reported complications. Medicine does not stand still, and we are now aware of the development of new surgical treatments for Bell's palsy (cross-plasty of the nerve, transposition of nerves and muscles). Minimally invasive methods of aesthetic correction are also used: eyebrow lifting with threads, cheek tissue suspension.

In domestic practice, the use of massage, therapeutic exercises and physiotherapy is widespread, but a number of authors doubt the effectiveness of these procedures and provide statistical data that such activities do not have a positive effect. Moreover, they note that their uncontrolled implementation can threaten the appearance of contractures and synkinesis.

Let's summarize. Facial paralysis is a disease that occurs suddenly and is accompanied by weakening of the facial muscles on one side or, in rare cases, only the lower half. The course of the disease can end with complete recovery or transition to a chronic form with a number of complications. Currently, facial asymmetry is indicated to be corrected using botulinum toxin. Special attention should be paid to preserving the eye on the affected side from the first days of the disease - failure to comply with this requirement can lead to complete blindness.