Neuritis of the facial nerve: symptoms and treatment
Neuritis of the facial nerve is defined as a one-sided lesion, formed in the seventh pair of cranial nerves. These nerves in particular are responsible for the movements produced by the facial muscles of one face. The clinical manifestation, characteristic of such a diagnosis as facial nerve neuritis, the symptoms of which are expressed in the impotence of the patient in controlling the facial muscles in the affected area, is the appearance of a facial asymmetry that appears due to paralysis of the muscles or paresis in the region of the corresponding half of the face.
Causes of the onset of neuritis of the facial nerve
In the vast majority of the situations considered, it is not possible to establish a specific cause of the onset and subsequent development of neuritis. Among the provoking factors, local supercooling is often the main factor (for example, a draft from a car window that helps to blow one half of the face, etc.), in some cases it can be combined with an infection (flu). The development of neuritis is also promoted by inflammatory processes in the middle ear region (mesotympanitis, otitis) and processes of the posterior cranial fossa (meningoencephalitis, arachnoencephalitis).
Often, a traumatic fracture or a crack that occurs at the base of the skull, tumors in the region of the bridge-cerebellar angle and operations that are aimed at eliminating the purulent process that arose due to otitis, mumps, mastoiditis, and other diseases contribute to the facial nerve injury. Diseases of a systemic nature, as well as diseases associated with metabolism, craniocerebral trauma in general, heredity — these factors should not be excluded as reasons for the development of the disease in question.
We also note that the disease in some cases is observed in its recurring, as well as in bilateral form.
Neuritis of the facial nerve: symptoms
External manifestations of neuritis are expressed, as we have already noted, in facial asymmetry, in which the wrinkling of the forehead skin folds or their absence is observed from the side of nerve damage. In addition, the eye gap also undergoes changes, which largely extends.
Smoothing and lowering occurs with a nasolabial fold, the lower lip hangs. Grinning of teeth to the patient, as well as laughter are accompanied by dragging the mouth to a healthy side. The opening of the mouth is characterized by a greater severity of its angle on the side of the lesion than when compared with a healthy area. Raising the eyebrows does not contribute to the formation of horizontal folds on the skin of the forehead, because the brow does not rise from the paralyzed side. Closing of the eyes is characterized by incomplete closure of the eyelids, in which the eye gap just juts from the side of the lesion, as if the patient is spying, screwing up her eyes. This symptom is defined as a lagophthalmus, the more common name of which sounds like a «hare eye.»
When considering such a condition as neuritis of the facial nerve, the symptoms of which have a pronounced character, it can also be noted that the patient loses the ability to stretch his lips «tube», can not whistle and kiss. During the reception of food, there is a jam between the teeth and the cheek, which was defeated. Reduced or completely absent corneal, superciliary and conjunctive reflexes. The degree of defeat also determines the addition to this disease picture of signs of flavors, which affects the area of the two anterior third of the tongue.
Hyperactases, as well as hypertension occurring in the area of the external auditory meatus, are actual phenomena. In some cases, the urgency acquires such a symptom as «crocodile tears», in which tears begin to flow in the process of eating, while the eye, which has been damaged, remains dry during the rest of the meal. There may also be an increased sensitivity, characteristic of hearing, in which the sounds from the side of neuritis are felt to be more loud.
The danger of neuritis of the facial nerve is the possibility of complications in the form of a contraction of facial muscles. It manifests itself in the characteristic reduction of half of a person who has been defeated, and in such a way that it seems as though the side is not paralyzed and the side is sick. It forms in the fourth to sixth week from the onset of the disease, which is facilitated by incomplete recovery of all motor functions.
Diagnosis of the facial nerve neuritis
To confirm the diagnosis, neuritis of the facial nerve, the symptoms of which disturb the patient, as well as to determine the degree of overall damage to the facial muscles, electromyography (or EMG) is performed, and appropriate studies are conducted to determine the conductivity peculiar at this particular stage to the facial nerve . To exclude another type of disease for brain research, magnetic resonance imaging or computed tomography may also be prescribed.
Treatment of neuritis of the facial nerve
Initiate treatment as soon as possible, because this is a possibility of preventing complications and the occurrence of residual phenomena. In particular, it is recommended to take corticosteroids — prednisone. It should be taken internally in the morning for five days, starting at 60 mg with a gradual decrease in dose and subsequent withdrawal from 10-14 days. This dose is safe and, at the same time, effective in considering the possibility of effective reduction of the nerve edema with a characteristic infringement of the intraosseous canal. In this case, a faster recovery occurs, and the pain that forms in the BTE area also disappears.
Given the openness of the eyelids and the violation in tearing, for the eyes should be used drugs used as an artificial tear. In addition, massage is also prescribed for the face, the occipital region and the collar zone. Initially, massage is done carefully, after which you can move to medium gain. A set of specific exercises is developed for the muscles of the face.
At the achievement of the so-called distant period, characterized by the abatement of the acute process and coming from 10-15 days, physiotherapy procedures are prescribed. Complicated cases in which treatment is made with difficulty, sedatives (reium, sibazon, seduxen) are used, which should be taken four times a day in a dosage of 5-10 mg. Also used for treatment and phenobarbital, which is taken three times a day at a dosage of 30-60 mg. With the action of these drugs, by reducing anxiety, muscle spasms decrease, by the same amount, as other manifestations of the disease are eliminated.
Secondary neuritis of the facial nerve determines the need for treatment, first of all, a disease that provokes them. With regard to recovery, it comes in time to 2-3 weeks, but for the final restoration of all functions will take a little longer — up to a year.
Naturally, to receive any type of medication, you need to get appropriate advice from a doctor. In this case, to diagnose and determine the course of treatment, you urgently need to visit a neurologist.