Facial neuropathy is an inflammatory lesion that innervates the muscles of the right or left half of the face. In this case, weakness develops, which leads to a decrease or complete absence of facial expressions and the occurrence of asymmetry.
The facial nerve is located in a narrow bony channel, in which it can be pinched if there is a violation of blood supply or inflammation. Especially people who have structural features and an anatomically narrow channel of the facial nerve are predisposed to facial neuritis. The disease can occur with hypothermia of the ear and neck, especially when exposed to air conditioning 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 (mumps), middle ear inflammation, and herpes infection. The disease can occur due to traumatic damage to the nerve of the face, its defeat due to impaired cerebral circulation, neuroinfection or tumor.
Usually, neuritis develops gradually. First, pain behind the ear appears, after a few days there is an asymmetry of the face. From the side of the lesion, the patient has a smoothing of the nasolabial folds, the face twists, 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 upside down.
Facial neuropathy weakens the facial muscles, which makes it impossible to move. The patient cannot smile, frown, grin, stretch his lips with a straw, raise an eyebrow. In patients with neuropathy, lagophthalmus is observed on the sick side - the appearance of a white strip of sclera between the lower eyelid and the iris of the eye.
A patient has a decrease or complete disappearance of taste sensations on the front of the tongue, lacrimation or dry eyes may begin .
In some cases, in the absence of the correct timely treatment for neuritis, trigeminal neuropathy may develop , expression muscles contracture may occur. Complications begin a month after the illness. Contractures begin to tighten the affected side of the face, cause involuntary muscle contractions, discomfort. The patient's face begins to look as if paralysis has spread to the healthy side.
Due to the brightness of the clinical picture, the diagnosis is not difficult. To exclude the secondary nature of neuritis, additional examinations are prescribed (magnetic resonance or computed tomography of the brain).
To determine the degree of damage and the location of the pathological process, electroneurography, Ξ²-myography and evoked potentials are prescribed.
Initial treatment begins with glucocorticoids, decongestants, vasodilators, B vitamins. Analgesics are prescribed to stop the pain. If secondary neuropathy of the facial nerve occurs, the primary disease is treated. The first week, the affected muscles need rest. From the very beginning of the disease, physiotherapeutic procedures are used - sollux, after the first week of the disease, a UHF course is prescribed along with contact heat using ozokerite or paraffin applications.
As with other neuritis, for example, if neuropathy of the ulnar nerve occurs, physiotherapy exercises and massage are performed. These procedures begin from the second week of the disease, gradually increasing the load. To improve conductivity, dibazole and anticholinesterase drugs are taken.
Full restoration of the facial nerve occurs no earlier than after 2-3 months.