Neuritis of the facial nerve: symptoms and treatment
Inflammatory disease of the VII pair of cranial nerves, which can occur after severe hypothermia, as a complication after viral and infectious diseases is called neuritis( neuralgia) of the facial nerve.In medicine, the name is used - "neuritis", "Bell's paralysis" or "neuropathy", depending on the cause of the disease.
The term "neuralgia of the facial nerve" is often used on the Internet, which is fundamentally an incorrect definition.Neuralgia, as a pain syndrome, can take place in the pathology of the facial nerve, but it does not occur in isolation as an isolated pain.In neuritis, there are necessarily motor disorders.
Note: some sources mistakenly confuse trigeminal neuralgia with neuritis( neuropathy) of the facial nerve.These are two completely different diseases that occur with a variety of symptoms and complaints.The triadic and facial nerve innervate different anatomical structures.We recommend that:
In case of neuritis( neuralgia) of the facial nerve, the patient can not frown and raise his eyebrows, is unable to smile, unable to drink and chew normally during meals.The patient's face is skewed.The process in most cases affects one nerve from a pair, so the manifestations of the disease cause asymmetry of the face.
What is the facial nerve
TotalA person has XII pairs of cranial nerves that contain their central nuclei in the brain, and the peripheral network - in different parts of the head.Each pair performs only its inherent functions and innervation.
VII pair - the facial nerve innervates the muscles involved in facial expressions - the circular muscle of the mouth, the occipital group, the styloid, the dorsal muscle( the posterior abdomen), the subcutaneous muscle of the neck.The motor nuclei of this cranial couple are near the medulla oblongata.The anatomical structure of the facial nerve is very complex.The path from the nucleus of the nerve to the muscles is very tortuous and passes through various anatomical formations of the head.
Causes leading to the development of Bell's paralysis
Neuritis of the facial nerve can develop when:
- is affected by the nerve fibers( swelling and inflammation) of the herpes virus, including causative agents of mumps, poliomyelitis, adenovirus infections and enterovirus;
- supercooling( as a result of decreased immunity).Prolonged spasm of blood vessels at the same time leads to disruption of nerve supply and pathology development;
- long-term use of alcohol.Alcohol is a neurotoxic poison and causes inflammation of the nervous tissue;
- hypertension, cerebral circulation disorder, stroke.In this case, small vessels also spasmodic and cause problems of trophic( feeding) of the facial nerve;
- hormone reorganization during pregnancy( especially in the first trimester);
- tumor diseases.A growing formation can squeeze the facial nerve, causing painful manifestations;
- craniocerebral and maxillofacial injuries, physical damage to the ear.Neuritis manifests itself as a result of direct damage to the nerve, or pressure on it by edematous tissue;
- dental diseases, penetration of infection from a tooth, caries-affected;
- diseases of the paranasal sinuses( sinusitis), middle ear( otitis).Inflammation of palatine tonsils, pharynx, nose, can also become sources of infections that damage the facial nerve;
- endocrine diseases( diabetes mellitus);
- occlusion of arterial vessels feeding the facial nerve with atherosclerotic plaques, as a result of which the nerve ceases to circulate;
- stressful situations, mental illness, in which there is a general depression of the immune system;
- Multiple Sclerosis.With this disease, the membranes of nerve fibers are destroyed, in particular, the damage to the facial nerve.
Mechanism of development of neuritis( neuralgia) of the facial nerve
Spasm of the arteries leads to stagnation of blood and sweating plasma in the tissue.This causes edema leading to compression of arteries, veins and lymphatic vessels, which aggravates edematous manifestations.
The blood supply of nerves is disturbed, the nerve tissue, as is known, very quickly undergoes destruction as a result of a lack of oxygen.The nerve trunk begins to swell, there are foci of hemorrhage.Nerve impulses lose the ability to pass.The signals sent from the brain and cortical structures do not reach the muscles-performers.This leads to the appearance of complaints in the patient and the symptoms of the disease.
Symptoms of neuritis of the facial nerve
Important: neuritis of the facial nerve always develops sharply.
Before the full formation of clinical manifestations, the patient may have pain behind the ear, giving to the face, the back of the neck, the eye socket( the beginning of edema of the nerve).
Gradually develops the inability of the brain to control the muscles of the face on the side of nerve damage.
The patient is observed:
- masked face on the painful side and loss of symmetry;
- wide opening of the eye, lowering of the angle of the mouth, smoothing of the nasolabial fold.These signs are especially evident when talking, trying to laugh, or crying;
- pouring liquid food from the corner of the mouth;
- frequent chewing of a cheek sick during a meal;
- dry mouth - a consequence of a violation of the innervation of the salivary gland, or vice versa - profuse salivation from the lowered corner of the mouth;
- problems with speech - indistinctness, especially when trying to pronounce sounds - "n", "b", "c", "f";
- dry eyes, rare blinking and the inability to close the eyes on the sore side, drying out and inflammation of the mucous membrane.Some people complain of excessive lacrimation;
- loss of taste on the front surface of the affected half of the tongue;
- increased sensitivity to sounds on the patient side( due to the proximity of the nuclei of the facial and auditory nerves.) The patient sounds sound louder, especially low.
Please note: for existing complaints and symptoms, an experienced neurologist may assume a lesion of the facial nerve.
Diagnosis of the neuritis( neuralgia) of the facial nerve
In the initial interview, listening to complaints and examination, the doctor asks the patient:
- to bring together and frown the eyebrows;
- raise your eyebrows up;
- wrinkling the nose;
- pull your lips into a tube and whistle;
- make a "blowing out of the candle";
- inflate in turns and together the cheeks;
- at the same time and in turn turn a blind eye;
- close tight eyes.
If the patient can not perform these exercises and when trying to close his eyes, he has a gap with the visible eye protein from the patient's side, then the doctor determines the presence of neuritis.
A person with neuritis( neuralgia) of the facial nerve is additionally treated with:
- a clinical blood test in which the erythrocyte sedimentation rate( ESR) increases for an infectious cause of the disease, leukocyte counts increase and lymphocytes decrease.Especially if the process is purulent.
- magnetic resonance imaging( MRI), which allows to detect tumor brain processes, traces of strokes and heart attacks, atypical vascular distribution, inflammatory processes of the brain tissue and its membranes;
- computed tomography( CT) scan of the brain.Especially informative is a new, digital modification of this study.CT allows you to distinguish between tumors, pathological foci after the development of a stroke, areas of brain tissue with a violation of blood supply, hemorrhage( hematoma);
- electroneurography( ENG) is a special diagnostic method that allows you to determine the rate of passage of a nerve impulse along the nerve trunks.For this, the nervous region is subjected to stimulation by an electric pulse in a certain place.
The distribution data is measured at other points and processed by computer programs.In the presence of neuritis, there are observed - a decreased pulse speed, or its absence.Also this method measures the excitation of muscles.A weak reaction indicates a developing muscular atrophy;
- electromyography( EMG) - allowing to record electrical impulses in muscles without external stimulation with the help of needle electrodes located on different sites.The data are measured both in a relaxed state and under tension.When the neuritis is observed, the delay in the passage of the pulse
- electroneurography( ENG) is a method similar to EMG, which allows measuring the magnitude of the impulse that appears in the nerve fiber.
Treatment of neuritis of the facial nerve
The treatment of neuritis necessarily takes into account the cause of the disease.
For therapy apply:
- diuretics( Lasix).Contribute to removing excess fluid from the body.The contents of edematous tissues are first displayed;
- non-steroidal anti-inflammatory drugs( Nurofen).Necessary to reduce the inflammatory process, relieve pain and reduce edema;
- hormonal medications( glucocorticoids - dexamethasone).They are used for severe symptoms of neuritis.The mechanism of action is the activation of neurotransmitters, which improve the conduction of a nerve impulse;
- antiviral drugs( Acyclovir).Brake the process of reproduction of the herpes virus - one of the causes of neuritis;
- antispasmodics( spasmalgon).Designed to eliminate excessive muscle contraction with symptoms of neuritis and to relax the walls of blood vessels, which improves blood supply to tissues;
- neurotropic drugs( carbamazepine).The purpose of the application is to improve metabolism in nerve cells;
- Vitaminotherapy( Thiamine bromide, Cyanocobalamin, Pyridoxine hydrochloride) - neurotropic vitamins, are involved in the metabolism of nervous tissue;
- anticholinesterase substances( Proserin).Improve the passage of impulses along the nervous processes.
Physiotherapy has a very beneficial effect, as an additional treatment for neuritis( neuralgia) of the facial nerve.
Ultrahigh frequency( UHF) waves, ultraviolet rays, electrophoresis with drugs, diadynamic current treatment, darsonvalization, applications of medicinal substances, ozocerite, mud therapy are used.
After the abating of active manifestations, balneological resorts are recommended.
Special therapeutic properties are provided by massage.Special methods are developed, most effective in neuritis.Successfully applied acupuncture.
Treatment of neuritis of the facial nerve by means of home medicine
Treatment in traditional medicine methods has long been used successfully for the removal of acute phenomena and for preventive methods.
The most effective methods:
- , calcined in a clean frying pan, rock salt, which must be poured into a linen or canvas bag and applied to sore spots;
- Acacia tincture, which is rubbed twice a day the surface of the skin over diseased muscles;
- solution mummy.Apply outside and inside;
- ointment applications of black poplar buds;
- infusion from the petals of a red rose.
The treatment of Bell's paralysis takes time, so all medical recommendations must be carefully observed.
Prognosis and prevention
With properly organized treatment, the effects of Bell's paralysis go away completely, or considerable relief comes.In the future, constant gymnastics for the muscles of the face and massage courses are required.
With inadequate therapy, the patient can develop: facial muscles atrophy, irreversible contraction of skin areas, chronic spasms and twitchings, chronic conjunctivitis, rhinitis.
Prophylaxis is to eliminate the causes that contribute to the onset of disease, hardening procedures.
Alexander Lotin, medical reviewer