Nervus facialis - how to restore the mobility of the muscles of the face

Facial nerve – This is the nerve that controls the facial muscles of the face. It allows us to express emotions – smile, cry, wink, etc. The facial nerve is the seventh of the twelve cranial nerves. A person has two facial nerves located on both sides of the face. Facial nerve problems can lead to muscle paralysis, weakness, or facial twitching. Also, problems of the facial nerve can manifest as dryness of the eyes or mouth, changes in the sense of taste on the affected side, or excessive tearing or salivation.

Symptoms of damage to the facial nerve can range from slight twitching to complete paralysis of muscles in one part of the face.

What diseases can cause damage to the facial nerve?

• injuries (at birth, damage to the base of the skull, trauma to the face, middle ear, surgical trauma);
• diseases of the nervous system, including stroke;
• ear or facial infections or shingles;
• tumors (including acoustic neuroma, schwannoma, cholesteatoma, parotid tumor, glomus tumor);
• toxins (poisoning by alcohol or carbon monoxide);
• idiopathic facial palsy (Bell's palsy, peripheral facial paralysis) sometimes develops with diabetes or pregnancy.

What are the causes of Bell's palsy?

Bell's palsy – This is a paralysis of the facial nerve, the cause of which is unknown. There is some speculation that it may be caused by a viral infection affecting the facial nerve.

Bell's palsy usually occurs suddenly and is not life threatening. This facial paralysis usually goes away on its own within six weeks. However, age or race does not play a role in the occurrence of Bell's palsy. However, it is worth noting that more often it occurs during pregnancy. Children under the age of 13 are less at risk of developing Bell's palsy than older people.

Symptoms of Bell's palsy – how to recognize facial paralysis

• acute unilateral paralysis of the facial muscles, including the muscles of the forehead;
• half the cases there is numbness or pain in the ear, face, neck or tongue;
• in most patients, Bell's palsy is preceded by a viral infection;
• in very rare cases, paralysis extends to both parts of the face;
• It is also possible to change the sensitivity of hearing (mainly hypersensitivity).

Mechanism of nerve damage in Bell's palsy

Recall that the mechanism of damage to the facial nerve in Bell's palsy is unknown, but there are several assumptions about this:

• previous viral infection;
• virus "lives" in the nerve for months or years;
• the virus is activated later;
• the virus multiplies and travels along the nerve;
• The virus infects the cells surrounding the nerve, causing inflammation;
• the immune system reacts to damaged cells, leading to inflammation of the nerve and subsequent weakening and paralysis of the face;
• The course of paralysis and recovery depends on the degree and extent of nerve damage.

Available Treatment Options for Facial Palsy

There are no approved drugs for the treatment of Bell's palsy. Treatment of facial paralysis begins with the treatment of diseases that led to nerve damage. Steroid drugs (corticosteroids) are recommended for all patients with facial paralysis. Antiviral medications such as acyclovir (Zovirax) are also given along with steroids to speed up recovery.

Facial exercises help prevent myogenic muscle contracture. Some surgeons recommend surgical decompression of the facial nerve for patients who have significant nerve degeneration. However, with this operation, the patient is at risk of hearing loss.

What is the treatment for an eye with facial paralysis?

In patients with facial paralysis, the eye does not close on the affected part of the face, because the muscles that perform this function do not work. If the cornea becomes too dry, it can lead to serious complications. Therefore, for an eye that does not close, assign:

• safety goggles that prevent dust from entering the eye;
• closing the eye manually with a finger to ensure it is properly moistened;
• artificial tears or ointments for eye swabs;
• eye patches while sleeping;
• blepharorrhaphy (temporary or permanent narrowing of the eye) in case of incomplete recovery.
• The following surgical options are also available for patients with muscle weakness or paralysis:
• surgical nerve repair or nerve grafts;
• nerve transposition;
• muscle transposition;
• muscle transplant;
• additional procedures (eyebrow or facelift, partial lip resection, etc.).