Psychiatry

Facial nerve paralysis

Human facial muscles, which provide speech, chewing and mimicry, are innervated by the VII pair of craniocerebral nerves, called the facial nerve. The defeat of nerve can arise up as a result of trauma, draught or inflammation. Paralysis or paresis of muscles, which are innervated by this nerve, appears. The eye of the affected side of the face is widely exposed, it is impossible to close it (lagophthalmos). There is a danger of drying out of cornea and connecting shell of eye. The affected side of the face droops, a mouth is twisted. At the damage of drum nerve pain in the ear can appear, there can be violations of the taste feelings at the irritation of counterfoils of tongue.

Symptoms

  • Incomplete closure of the eyelids.
  • At an attempt to blink an eyeball is displaced upwards.
  • A mouth is twisted.
  • The taste feeling is broken.
  • The mimic muscles of the staggered part of person are weakened.

Causes

Possible causes of facial nerve paralysis – meningitis (inflammation of shells of cerebrum), viruses or other microorganisms can stagger a nerve. Such paralysis can be one of the first symptoms of infectious disease – Lyme disease. Other possible causes of facial nerve paralysis or paresis are different craniocerebral traumas, for example, break of foundation of skull, and also heavy inflammation of middle ear or tumor of parotid salivary gland.

Treatment

At appearance of lagophthalmos (it is impossible fully to close an eye), which arises up because of paralysis of circular muscle of eye, antibiotic ointment is entered in the opened eye at night. Disinfectant and nourishing substances drop in the conjunctiva of eye. That a cornea did not dry out, the special «glass» bandage is laid on an eye or drops are used . In heavy cases the ends of eyelids are sewn together or during an operation the damaged nerve is connected with the counterfoils of nerves that pass nearby.

The regular trainings of facial muscles are instrumental in convalescence.

At a sudden paralysis which does not pass during a day, it is necessary to appeal to the doctor.

Treatment of inflammation of facial nerve is conducted with anti-inflammatory drugs. An eye is oiled with antibacterial and moistening preparations, artificial tears are used. In addition, a facial massage and special exercises is recommended for training of the muscles of the face. At the heavy course of the disease an operation is required. After a successful operation practically all symptoms of facial nerve paralysis usually disappear.

Course of the disease

Often the first symptoms of facial nerve paralysis arise up suddenly. Through a few clock or days the paralysis of muscles can make progress from the insignificant hanging down of corner of lips to the complete paralysis of one side of the face and lagophthalmos.

At timely treatment a facial nerve paralysis is curable. The greatest danger is caused by the drying of the cornea: sight can strongly become worse, even to come blindness.

Bell’s palsy

A patient cannot close an eye because of expansion of an eye crack. When a patient tries to close the eye of the staggered side of the face, the eyeball is directed upwards. This protective mechanism is typical for a healthy person. However when an eyelid closes the eyeball, it is not visible. The first, who described the symptom of facial paralysis, was English surgeon Charles Bell (1774-1842). That’s why it is called Bell’s palsy.