Neuropathy of the facial nerve: clinical picture of the disease

Neuropathy of the facial nerve is an inflammatory lesion innervating the muscles of the right or left half of the face. In this case, weakness develops, which leads to a decrease or total absence of facial expressions and the appearance of asymmetry.

The facial nerve is located in a narrow bone channel, in which, if there is a violation of the blood supply or inflammation, it can be jammed. Especially in the neuritis of the facial nerve, people with structural features and an anatomically narrow channel of the facial nerve are predisposed. The disease can occur with supercooling of the ear and neck area, especially when exposed to an air conditioner or draft.

Neuropathy of the facial nerve can be primary, developing in a healthy person after hypothermia (catarrhal form), and secondary, which is a complication of other diseases: mumps (epidemic parotitis), inflammation of the middle ear, herpetic infection. The disease can occur due to traumatic nerve damage to the face, its damage due to cerebral circulation, neuroinfection or tumor.

Usually neuritis develops gradually. First there is a pain behind an ear, in some days there is an asymmetry of the face. On the part of the lesion, the patient has a smoothing of the nasolabial fold, the face twists, the corner of the mouth falls. It is impossible for a person to close his eyelids, when he tries to perform this action, his eyes turn upside down.

Neuropathy of the facial nerve weakens the facial muscles, which causes the inability to move. The patient can not smile, frown, grin, draw a tube of the lips, raise an eyebrow. In patients with neuropathy from the patient side, a lagophthalmus is observed-the appearance of a white scleral band between the lower eyelid and the iris of the eye.

At the patient on the front part of the tongue there is a decrease or complete disappearance of sensations of taste, lacrimation or dryness of the eyes may begin .

In some cases, in the absence of proper timely treatment of neuritis, trigeminal neuropathy can develop , contraction of facial muscles may occur. Complications begin in a month from the moment of illness. Contractures begin to pull together the affected side of the face, cause involuntary muscle contractions, discomfort. The face of the patient begins to look as if paralysis has embraced and healthy side.

Due to the brightness of the clinical picture, the diagnosis is not difficult to diagnose. To exclude the secondary nature of neuritis, additional tests (magnetic resonance imaging or computed tomography of the brain) are prescribed.

To determine the extent of the lesion and the location of the pathological process, electroneurography, -mography and evoked potentials are prescribed.

Treatment at the initial stage begins with glucocorticoids, decongestants, vasodilators, vitamins of group B. To stop pain, prescribe analgesics. If there was a secondary neuropathy of the facial nerve, the primary disease is treated. The first week of affected muscles requires rest. From the very beginning of the disease, physiotherapeutic procedures are used - the sollyx, after the first week of illness, the UHF course is prescribed together with contact heat with ozokerite or paraffin applications.

As with other neuritis, for example, if there was neuropathy of the ulnar nerve, they produce therapeutic exercise and massage. These procedures begin with the second week of the disease, gradually increasing the load. To improve conductivity take dibazol and anticholinesterase drugs.
Complete recovery of the facial nerve occurs not earlier than in 2-3 months.