Neuritis of the facial nerve
Neuritis of the facial nerve is a neurological disease characterized by a lesion of the facial nerve, provoked by an inflammatory process. Because of this, there is a violation of the functioning of the muscles, which causes the asymmetry of the face. In addition, the patient is deprived of the opportunity to show his emotions — he cannot frown, smile, raise his eyebrows. The face looks distorted and asymmetrical. Neuritis of the facial nerve is a common disease, since about 25 people out of a hundred suffer from this disease every year.
The content of the article:
Classification of facial nerve neuritis
Symptoms of facial neuritis
Diagnosis of facial nerve neuritis
Complications of facial neuritis
Treatment of facial neuritis
Prognosis for facial neuritis
Prevention of neuritis of the facial nerve
Neuritis of the facial nerve
Statistical studies have shown that the surge of the disease mainly occurs during the cold season. In most people, the pathological process affects only one side of the face. Only in 2% of cases, inflammation is observed from two sides at once. Treatment takes a lot of time, and for a full recovery it is necessary to spend at least three months.
Classification of facial nerve neuritis
The classification of facial nerve neuritis is based on the etiological factor: primary and secondary forms of pathology are distinguished. The primary form of neuritis occurs after severe hypothermia. The most dangerous is considered to be local hypothermia, which provokes spasm of muscles and blood vessels, which leads to a violation of nerve nutrition and its further inflammation.
Secondary neuritis of the facial nerve is considered a complication of various diseases and injuries:
Herpes virus. A decrease in immunity activates the herpes virus, which lives in the body of most people. Since the virus is localized mainly in nerve fibers, there is an inflammatory process and swelling of the facial nerve. In addition to the herpes virus, the disease can also be triggered by the following viruses: mumps, polio, enterovirus and adenovirus.
Hypertension. Pathology provokes an increase in intracranial pressure, in which the nuclei of the facial nerve suffer. Hypertension can trigger a stroke. Neuritis of the facial nerve in this case will occur if a hemorrhage occurs near it.
Traumatic brain injury. Due to a strong impact, injury and rupture of nerve fibers occur, after which swelling occurs in the damaged area and inflammation begins to cover the entire nerve.
Atherosclerosis. In this disease, the capillaries that supply the nerve with blood clog the fatty plaques. As a result, the nerve starves, and its cells die.
Transferred otitis media or sinusitis. Various diseases of ENT organs provoked by bacteria and viruses can spread to surrounding tissues and provoke compression of the facial nerve.
Symptoms of facial neuritis
The symptoms of neuritis of the facial nerve appear gradually, over time, new symptoms of pathology appear. At the beginning of the disease, patients are concerned about severe pain near the ear, which appears due to swelling of the nerve. Usually the pain goes to the face and the back of the head, and after a few days it spreads to the eyeball.
A pronounced symptom of the pathology is an asymmetrical face, which looks a little like a mask from the affected side: the eyes are wide open, the nasolabial fold is smoothed, the corner of the mouth is lowered. During a conversation, crying or laughing, the asymmetry of the face becomes more pronounced. Patients may not close their eyes from the inflamed side. If the patient tries to close his eyes, the eye will not close completely and there will be a small gap through which the protein shell will be visible.
Another noticeable manifestation of the disease is the omission of the corner of the mouth. The patient retains the ability to chew and move his jaw, but liquid food falls out on one side during meals. The patient is concerned about constant dry mouth, but sometimes the disease is accompanied by profuse salivation. Since half of the mouth is not involved in articulation, speech eventually becomes slurred.
In some patients with neuritis of the facial nerve, excessive dryness of the eyeball appears, while in others, on the contrary, increased lacrimation. In both situations, the cause of the pathological condition is a violation of the functioning of the lacrimal gland. The perception of taste completely disappears in half of the tongue. Patients also note an increased sensitivity of hearing, because the sounds seem much louder to them.
Diagnosis of facial nerve neuritis
When making a diagnosis, the neurologist focuses on the results of the patient’s examination, his complaints, laboratory and instrumental studies. All these studies are more focused on finding out the causes of the disease. To identify the localization of the pathological process and the degree of nerve damage, the doctor prescribes such techniques as electromyography, electroneurography and evoked potentials. A general blood test is required to confirm signs of bacterial inflammation. A positive result may indicate otitis or meningitis.
A neurologist can also prescribe an MRI and CT scan of the brain to identify pathologies that could provoke the disease: tumors or inflammation of the brain, stroke or cerebral infarction, the consequences of traumatic brain injuries. Depending on the results of these studies, the doctor draws up a treatment plan that may involve restoring blood circulation or removing the tumor.
Complications of facial neuritis
Nerve cells recover very slowly, which significantly complicates the treatment process. If the doctor chooses an ineffective treatment tactic or the patient abandons him, this can provoke serious complications. The patient may have muscle atrophy — they will weaken and decrease in volume. Atrophy begins to develop a year after the onset of the disease and is irreversible.
An equally serious complication is the contracture of facial muscles — their tightening and loss of elasticity. At the same time, the muscles become very painful and throb weakly. The patient has a muscle spasm, after which they tighten the affected side of the face. Another complication of neuritis is involuntary muscle twitching — a rhythmic contraction of facial muscles that a person cannot control. Conjunctivitis and facial synkinesia are also considered serious consequences of neuritis.
Treatment of facial neuritis
Treatment of facial nerve neuritis includes drug therapy, physiotherapy, massage. According to the indications, surgical treatment or facial nerve surgery may be prescribed.
Medical treatment
Drug therapy of facial nerve neuritis involves the use of the following groups of drugs:
nonsteroidal anti—inflammatory drugs – relieve inflammation, help relieve painful sensations;
diuretics — accelerate the excretion of urine from the body, so that the tissues are deprived of edematous fluid, which avoids vascular compression and nerve edema;
steroid anti—inflammatory – relieve swelling, inflammation and pain in nerve fibers, activate the production of a neurotransmitter that improves the conduction of impulses along nerve fibers, and also prevent the appearance of contractures;
antispasmodic — eliminate vasospasm, improve blood circulation, dilate arteries, reduce pain;
antiviral — stop the activation of the herpes virus;
anticholinesterase — promote the conduction of a signal along the nerves in the muscles, which normalizes the work of the lacrimal and salivary glands;
B vitamins — reliably protect the nervous system from poisoning by its toxins;
neurotropic — contribute to the normal functioning of nerve cells, have an analgesic effect, improve the functioning of the nervous system, reduce nervous tic.
Physiotherapy treatment
Starting from the second week of therapy, the doctor prescribes physiotherapy. If the patient has inflammation in the facial nerve and circulatory disorders, UHF is prescribed. During the procedure, charged particles penetrate into the cells, the tissues heat up, their nutrition improves and edema is eliminated. The procedure of ultraviolet irradiation relieves inflammation and eliminates pain syndrome. Decimeter therapy is indicated for vasodilation, improvement of blood supply and restoration of impaired nerve functions.
Electrophoresis of medicinal substances has an anti-inflammatory, analgesic and decongestant effect. With this technique, it is possible to inject the necessary medications in high concentration directly into the focus of inflammation under the skin. In case of muscle paralysis, nerve fiber damage and contractures, diadin therapy is indicated. During this procedure, pulsed direct currents penetrate the muscle fibers through the skin, which provoke their contraction. They also accelerate the recovery processes in nerve fibers.
Surgical treatment
If the desired results have not been achieved within 8-10 months from the start of drug treatment, doctors turn to surgical treatment of facial nerve neuritis. The operation is indicated only in the first year of the disease, since irreversible changes in the muscles may occur in the future, so it turns out to be ineffective. Indications for surgical treatment are as follows: nerve rupture in case of traumatic neuritis, nerve degeneration, lack of positive effect from conservative treatment.
Prognosis for facial neuritis
The prognosis for patients depends on the diseases associated with neuritis and the localization of inflammation. It is usually possible to achieve a complete recovery of the patient. The patient spends at least 20 days in the hospital. After discharge from the hospital, the process of full recovery may take about 3-6 months. In 5% of patients, muscle function does not recover after treatment. This happens if the disease was caused by a traumatic brain injury or tumor. In 10% of cases, a relapse of the disease is possible at the end of treatment.
Prevention of neuritis of the facial nerve
It is possible to prevent neuritis of the facial nerve if hypothermia, especially local, is avoided. Namely, it is advisable not to sit in transport near an open window, not to stay under the air conditioner for a long time, it is necessary to wear a hat in the cold. Doctors also advise to avoid stress for the prevention of neuritis, eat right, take vitamins. It is also useful to harden, because in this way you can strengthen the body’s defenses and reduce sensitivity to hypothermia. To do this, you need to take a contrast shower regularly, each time slightly lowering the water temperature.
