Neuropathy of the facial nerve is inflammatory.lesion, innervating the muscles of the right or left half of the face. At the same time, weakness develops, which leads to a decrease or complete absence of facial expression and the appearance of asymmetry.
The facial nerve is located in a narrow bone canal, inwhich if blood supply or inflammation is impaired, it may be pinched. Especially people with structures and anatomically narrow canal of the facial nerve are predisposed to the neuritis of the facial nerve. The disease can occur when the ear and neck area is too cold, especially when exposed to air conditioning or drafts.
Neuropathy of the facial nerve may be primary,developing in a healthy person after hypothermia (catarrhal form), and secondary, which is a complication of other diseases: mumps (mumps), inflammation of the middle ear, herpes infection. The disease can occur due to traumatic nerve damage to the face, its damage as a result of cerebrovascular accident, neuroinfection, or a tumor.
Usually neuritis develops gradually.First, there is pain behind the ear, after a few days there is asymmetry of the face. On the part of the lesion, the patient has a smoothing of the nasolabial fold, the face is twisted, the corner of the mouth drops. It is impossible for a person to close his eyelids, when trying to perform this action, the eye turns upward.
Neuropathy of the facial nerve weakens mimicmuscle, which makes it impossible to move. The patient cannot smile, frown, grin, stretch the lips of the tube, raise an eyebrow. In patients with neuropathy on the sore side, lagophthalmos is observed - the appearance of a white sclera strip between the lower eyelid and the iris.
The patient on the front of the tongue there is a decrease or complete disappearance of the sensations of taste, tearing or dry eyes may begin.
In some cases, in the absence of the correcttimely treatment of neuritis, can develop neuropathy of the trigeminal nerve, contracture of facial muscles occur. Complications begin one month after the illness. Contractures begin to affect the affected side of the face, causing involuntary muscle contractions and discomfort. The face of the patient begins to look as if paralysis has engulfed the healthy side.
Due to the brightness of the clinical picturethe diagnosis does not cause difficulties. To exclude the secondary nature of neuritis, additional examinations (magnetic resonance imaging or computed tomography of the brain) are prescribed.
To determine the degree of damage and the location of the pathological process, electroneurography, -miography and evoked potentials are prescribed.
Лечение на первоначальном этапе начинают с glucocorticoids, decongestants, vasodilators, vitamins of group B. Analgesics are prescribed to stop the pain. If secondary neuropathy of the facial nerve occurs, the primary disease is treated. The first week affected muscles need rest. From the very beginning of the disease, physiotherapeutic procedures are applied - sollux. After the first week of the disease, a UHF course is prescribed together with contact heat using ozocerite or paraffin applications.
As with other neuritis, for example, ifthere was neuropathy of the ulnar nerve, produce physical therapy and massage. These procedures begin with the second week of the disease, gradually increasing the load. To improve the conductivity take Dibazol and anticholinesterase drugs.
Full restoration of the facial nerve occurs no earlier than 2-3 months.
