Neuritis of the facial nerve is a neurological disease in which 7 pairs of cranial nerves are damaged. Another name is Bell's palsy.
Neuritis of the facial nerve is most common in comparison with the paralysis of the other 11 cranial nerves. The incidence of pathology is 25 cases per 100,000 population per year.
What is this disease, and how can it be recognized? Let's figure it out.
What it is?
Neuritis of the facial nerve, or Bell's palsy, is an inflammatory neurological disease in which the nerve is damaged, which is responsible for the innervation of the mimic muscle. As a rule, only one half of the face suffers. As a result of inflammation, paresis (weakness) or total loss (paralysis) of mimic movements develops. Such a violation causes the appearance of asymmetry of the face.
The facial nerve passes through a narrow bone canal, where it is possible to pinch (tunnel syndrome) in case of circulatory disorders or inflammations. Most of all, people with a specific narrow structure of the bone canal and facial nerve are prone to neuritis.
Hypothermia of the neck or ear may be sufficient for the development of such a pathological process.
Causes of development
The development of neuritis of the facial nerve can be triggered by:
- Herpes Herpes viruses affect the nerve fibers, causing their inflammation and swelling.
- Viral diseases like parotitis, poliomyelitis, adenoviruses, enteroviruses.
- Hypothermia. It is extremely dangerous to overcool the face, which leads to a spasm of its muscles and blood vessels. As a result of this, the facial nerve is inflamed.
- Alcohol abuse. Alcohol has a negative effect on the nervous system, and can trigger the development of inflammatory processes in the nerve fibers. In addition, ethanol can extremely adversely affect the work of the brain.
- Hypertensive heart disease. Pathology is accompanied by an increase in ICP and damage to the facial nerve nuclei. In addition, hypertension can lead to stroke, and if hemorrhage occurs near the facial nerve, it leads to its inflammation.
- Pregnancy. Often women suffer from neuritis in the first trimester of pregnancy, since during this period a serious hormonal surge occurs.
- Brain tumors. If it puts pressure on the nerve endings, they cannot fully transmit nerve impulses, leading to neuritis.
- Transferred head injury and ear injuries. Under such circumstances, the nerve can be significantly damaged, and sometimes torn.
- Dental procedures. Sometimes during dentistry, the doctor may unintentionally injure the facial nerve, as a result of which it may become inflamed.
- Otitis and sinusitis. The spread of a bacterial or fungal infection to tissues adjacent to the nasal sinuses or ear canals, can lead to damage to the nerves innervating them. This often becomes a predisposing factor for the development of neuritis.
- Diabetes mellitus In this case, neuritis occurs due to metabolic disorders and hormonal imbalance.
- Atherosclerotic disease. In this disease, the nerve-feeding collaterals are occluded with cholesterol plaques. As a result, hypoxia develops, and the nervous tissues begin to die out.
- Stress and depression. Against the background of constant or extremely severe stress, the immune system weakens with a parallel violation of the activity of the central nervous system. Against this background, neuritis can develop.
- Multiple sclerosis. In this case, the myelin sheath of the nerve is affected, on the surface of which plaques are formed. In patients with this diagnosis, the facial and optic nerves are often inflamed.
At the beginning of the development of pathology, the patient suffers from pain behind the ear, radiating to the face, orbit, occipital zone. The mobility of the affected area of the face is gradually disrupted.
In parallel with this, the patient noted other symptoms of neuritis of the facial nerve:
- loss of symmetry of the face;
- dropping the corner of the mouth on the affected side;
- smoothing nasolabial folds;
- pouring fluid from a lowered corner of the mouth;
- frequent biting of the inside of the cheek during meals;
- violation of the secretion of saliva, expressed in dry mouth or, conversely, increased salivation;
- problems with the pronunciation of individual sounds and letters, in particular, "p", "b", "c", "f";
- dry ocular mucosa;
- inability to completely close the eye on the affected side;
- loss of taste perception of the tongue from the patient side;
- hypersensitivity to sounds from the inflamed nerve.
An experienced neuropathologist can only recognize the neuritis of the facial nerve for these symptoms, although additional tests are needed to verify the diagnosis.
In the absence of timely or correct treatment, neuritis can give a number of complications. First of all, he is able to provoke the formation of contractures of the facial muscles of the face. Usually they develop after 4 - 6 weeks from the moment of development of the disease, and become the result of incomplete restoration of the functioning of the facial muscles.
Contractures cause the affected area of the face, which causes discomfort and involuntary contractions of the muscles. At the same time, the face of the patient with neuritis looks as if the healthy side of the face is affected by neuritis.
Treatment of facial nerve inflammation
With the timely start of treatment of neuritis of the facial nerve, you can fully restore the function of the facial muscles, and in special cases - to prevent the recurrence of the disease.
Drug therapy of neuritis is based on the use of:
- GCS and NSAIDs - Prednisolone, Dexamethasone, Meloxicam, Nimesulide, Piroxicam. Medications in these groups help to stop inflammation and pain.
- Antibiotics - Amoxicillin, Tetracycline, etc. Their use is necessary to prevent the development of bacterial infections.
- Vasodilator drugs - Eufillin, Theophylline, nicotinic acid, etc. They help to improve blood circulation in the damaged area.
- Diuretics - Furosemide, Torasemide, etc. Diuretic drugs relieve swelling.
- Analgesics and antispasmodics - Analgin, Paracetamol, Solpadein, Spazmalgona, Kombispazm and so on. Such drugs stop spasm and pain.
- Neurometabolic drugs - Berlithion, Thiogamma, etc. They are used to accelerate the regeneration of damaged muscle tissue.
A special role in the treatment of neuritis is given to physiotherapy. They are prescribed from 7–10 days of the course of the disease to enhance the effect of medications, stimulate blood circulation, improve the conductivity of damaged nerves, prevent the formation of muscle contractures.
Thus, patients are given sessions of UHF, magnetic therapy, laser therapy, radiation IF, dynamic currents, electrophoresis with prozerin, nicotinic acid, Eufillin, calcium chloride, etc. The electrical stimulation of the trigeminal nerve and darsonvalization give good results.
Massages can be performed from 5 to 7 days after the onset of the disease. Main principles of implementation:
- Before the start of the massage, you need to make several rotational movements of the head in both directions for warming up the neck muscles.
- First you need to massage the back of the head and neck.
- Then you can proceed to massage the patient and the healthy zone of the head.
- Particular attention is paid to massage the face, mastoid process, neck area and neck.
- Initially, the movement must be superficial. Gradually, you can make them more tangible, vibrational.
- The direction of movement - on the current lymph.
- The face should be massaged with the fingers from the center of the chin, nose and forehead towards the ears.
- Lymph node localization zones cannot be massaged, as this can lead to their inflammation.
- Next you need to perform such an exercise. Place your thumb on the cheek and stretch their muscles. At the same time, it is necessary to thoroughly work out the muscles of the outer part of the cheek with the index and thumb of the second hand.
- The final stage is the development of the neck muscles.
The duration of the massage is at least 10-15 minutes. Repeat sessions are necessary until the complete disappearance of symptoms of inflammation. The best option is to conduct procedures in the office of a professional masseuse.
An alternative method of treating neuritis is acupuncture, which is carried out only by a competent specialist (since not every doctor has the skills to perform this manipulation). The essence of the procedure is the introduction of special thin, sterile needles into certain reflexogenic points. Due to this it is possible to cause irritation of the nerve fibers.
Folk remedies for neuritis are practically useless. Moreover, they can be dangerous, capable of causing even more intense inflammation of the trigeminal nerve.
But in some cases, doctors allow patients to conduct additional therapeutic procedures at home with the use of chamomile decoction compresses. It is also allowed to use dry heat and rubbing the face with ointments based on plant extracts.
Surgical intervention is indicated, first of all, for patients whose neuritis is the result of nerve compression. The lack of a therapeutic effect for 3 months is also the basis for the operation. But, no single method of treatment provides a 100% positive prediction of complete recovery.
In case of contracture of the facial muscles, plastic surgery is indicated. But such a need arises only in 3% of cases. However, the surgeon can only eliminate the cosmetic defect, but the muscle function will remain impaired.
However, in most cases, the complex of therapeutic measures prescribed by an experienced neurologist, helps to completely recover from an unpleasant disease.
If neuritis occurs several times in a row on the same side of the face, it is said about its chronic, recurrent form. In this case, the therapy will be longer, and the chances of recovery are lower. But the re-development of pathology can be avoided thanks to:
- Avoiding hypothermia. Especially it concerns hypothermia of the ears and the face itself. Even the smallest drafts are dangerous, so you shouldn’t stay near the air conditioner, the open window or other sources of continuous air intake.
- Timely treatment of viral pathologies. Therapy should be started immediately after the appearance of the first alarming symptoms, and carried out with the help of Groprinosin, Amizon, Helpex and other antiviral medications. You can use instead of tablets nasal drops (Viferon), including for kids (Laferobion).
- The rehabilitation period in the sanatorium-resort areas: Yessentuki, Pyatigorsk, Magnitogorsk, etc.
- Conducting self-massage sessions. During the year it is necessary to massage the face along the massage lines for 10 minutes twice a day. For this it is necessary to put palms on the face, then lower the muscles of the healthy side downwards, and lift the patient upwards. Such exercises will help get rid of the residual effects of the disease, and prevent its recurrence.
- Avoiding stressful situations. Stress weakens the immune system and negatively affects the nervous system. You can deal with it through meditation or auto-training, or by taking sedatives.
- Proper nutrition. The main goal is to strengthen the immune system, so a special place in the menu should be given to meat, dairy products, eggs, vegetables and fruits.
- Reception of vitamin complexes. If the immune system is greatly weakened, then it will not be possible to do without taking multivitamins. Preference should be given to those drugs that contain in their composition vitamins of group B. They are part of the cell membranes of nerve fibers, and take part in the transmission of impulses through them.
- Hardening of the body. Gradual and proper hardening can significantly strengthen the immune system, as well as increase the body's resistance to the effects of cold. You can start with sunbathing - sunbathing under the sun (a visit to the solarium is not considered a method of hardening!). Then you should accustom yourself to the contrast soul. This should also be done gradually, to begin with, the contrast in water temperature should not exceed 3 degrees. As the habituation takes place, the gap in temperature must be increased. It is recommended to make water colder every week.
Compliance with these rules and recommendations helps to strengthen the immune system, which, in turn, makes the body more resistant to infectious attacks. And timely treatment of diseases of the nasopharynx and ear is an effective prevention of not only neuritis, but also other complications.
The prognosis for neuritis in most patients is favorable: in almost 75% of cases, the pathology can be cured. But if the symptoms persist for more than 3 months, and treatment does not help to eliminate it, then the chances of recovery are greatly reduced.
If the etiology of neuritis is associated with trauma or ear pathology, then recovery may not occur at all. In the chronic form of the disease, each subsequent relapse is tolerated harder, and the recovery period is prolonged.