Correction of neurological complications that may develop after the placement of cosmetic threads – This is a joint work of an aesthetic doctor and a neurologist. However, the effectiveness of such treatment depends, first of all, on the competent actions of the cosmetologist – his quick and correct assessment of the situation, the ability to recognize a neurological lesion, to alleviate the patient's condition. Read about some clinical manifestations of damage to the most important facial nerves and about the possibilities of treating neurological complications in a cosmetology clinic at estet-portal.com.
How do neurological complications appear after thread implantation
When patients with neurological disorders come after thread implantation – these are always quite traumatic situations. They represent by far the most difficult group of patients for a neurologist.
All patients, no matter which nerve is damaged, tell the same story. During the procedure, they have a sudden sensation of electric shock – very strong, from which the patient literally jumps.
A burning pain immediately develops at the site of innervation of the damaged nerve. It is aggravated by the slightest hypothermia, because the nerve does not like the cold. Accompanying symptoms – numbness, allodynia, paresthesia in the zone of innervation of the damaged nerve. It is difficult for the patient to stay on the street (he tries to cover his face with his hand), it is difficult for him to wear a hat.
Without therapy, pain and sensory disturbances recede slowly, practically do not recede. Therefore, if the situation nevertheless occurred, it must be understood that a certain nerve was injured and the patient should not be left unattended.
Manifestations of neurological complications depending on the affected nerve
Now let's look at the lesions of specific nerve branches, which are most often encountered during implantation of threads.
Trigeminal nerve
Exits from the frontal foramen and runs close to the periosteum under the frontalis muscle; here it innervates the conjunctiva and the skin of the upper eyelid. Further, it pierces the muscle that shifts the eyebrows and the frontalis muscle, and its branch reaches the central part of the forehead.
Supraorbital nerve
Exits from the supraorbital foramen, located deep under the frontalis muscle, leading to the upper eyelid, to the conjunctiva. Then it rises higher and divides into medial and lateral branches, which supply the scalp almost to the occipital bone. The medial branch perforates the frontalis muscle and lies subcutaneously. The lateral branch pierces the supracranial aponeurosis and passes between it and the periosteum.
When threads are placed in the area between the eyebrows, the eyebrows, there is a feeling of an electric shock, from which the patient practically jumps, and then a constant, monotonous pain of a burning, breaking character develops in the superciliary, interbrow, frontal areas. It radiates to the region of the orbit and back of the nose, accompanied by hypoesthesia, paresthesia, and allodynia in this area. It is noticed that all patients have an obsessive thought about inflammation in the eye area, and they turn to ophthalmologists for help.
Infraorbital nerve
The largest cutaneous branch of the maxillary nerve. Comes out of the infraorbital foramen. The most dramatic thing about this nerve is that it exchanges its branches with the zygomatic and buccal branches of the facial nerve. Therefore, its defeat is aggravated by the fact that there is a spasm of facial muscles from the side of the lesion. The area of irradiation of pain is the most extensive when it is damaged.
What is the clinical manifestation of infraorbital nerve neuropathy
Constant monotonous pain of a burning, buzzing character. The patient describes it as a cold burning sensation. Localization of pain – infraorbital region, along the zygomatic arch.
Extensive irradiation:
• back, wing, nasal cavity, "congestion" nasal passage;
• orbit of the eye, feeling of "foreign body" in the eye;
• maxillary teeth;
• ear.
Accompanying symptoms: hypoesthesia, allodynia, paresthesia of the middle part of the face, pastosity of soft tissues on the side of the lesion, weakness of mimic muscles.
It is difficult to stay outdoors, in air-conditioned rooms.
Lingual nerve
The branch of the mandibular nerve runs in depth along the body of the mandible and provides sensory innervation to the lateral surface of the tongue. Despite the deep occurrence, his defeat – one of the most common types of neuropathy.
During the procedure, usually from the zygomatic region, the patient feels a sharp pain of high intensity ("electric shock") on the lateral surface of the tongue. Immediately develops swelling and burning pain on the lateral surface of the tongue, parotid-chewing area. The pain radiates to the floor of the mouth, the angle of the lower jaw.
Relief comes from chewing gum and mints. The pain intensifies after the slightest hypothermia (cold water or food), stress load.
Glossopharyngeal nerve
Mixed nerve, related to both somatic and autonomic innervation, contains motor, sensory, special taste and secretory fibers. It is a sensitive gustatory nerve for the posterior third of the tongue and palate, for the middle ear and pharynx, pharyngeal muscles, and a secretory nerve for the parotid salivary gland.
When affected, the following are observed:
• Loss of taste on the same side on the posterior third of the tongue.
• Anesthesia of the mucosa of the upper half of the pharynx.
• Swallowing disorders, which are usually minor.
• There may be fainting on the background of bradycardia, a drop in blood pressure.
One-sided exclusion of the nerve from the function is compensated by the activity of the remaining salivary glands, so dry mouth may be absent or be insignificant.
What happens to a patient with a lesion of the glossopharyngeal nerve
Constant burning pains in the region of the root of the tongue and sublingual region. Episodically, the pain takes on the character of a "hot wave".
The pain radiates to the throat, upper palate, ear and behind the ear, the floor of the mouth.
Accompanying symptoms:
• unpleasant sensations in the throat, in the region of the palatine arch ("something interferes", "tight tourniquet"); in connection with this, the patient often coughs;
• in the morning, a burning sensation in the ear (auricle, external auditory meatus) worries, during the day there is a "congestion"; in the ear.
Factors aggravating pain: cold, lying on one side (on the side of the lesion).
Objectively, there is hypoesthesia, hyperesthesia of the root of the tongue on one side, pain on palpation of the palatine arch.
Some options for the treatment of neurological complications
Of course, the patient should be referred for a consultation with a neurologist, but some appointments can be made in an aesthetic clinic.
Principles of the treatment of neuropathic pain
It is desirable to start therapy with droppers and injections, then move on to tablet forms of drugs.
Thioctic acid preparations
• Berlition-600 mg (Thioctacid – 24 ml, Espa-lipon, Thiogamma);
• Phys. solution 200 ml, in / in, drip, for 30 minutes. Wrap the bottle with a dark cloth. A total of 5 to 10 drips.
Then taking pills: Thioctacid – 600 mg in the morning half an hour before breakfast, for 1-2 months.
Venotonics (Detralex, Phlebodia) for 2-3 months;
Amitriptyline – 25 mg, ½ tablets at night for 1 week, 1 tablet at night – starting from the 2nd week and within 1 month.
Therapy of movement disorders in the face: the use of neuroprotein type A
Step 1. Determine the innervation of which muscles is affected on the affected side.
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