Neuritis of the facial nerve: treatment, symptoms, causes. Treatment time for facial nerve neuritis Is it possible to restore damaged facial nerve redness

Acute pain in the face, swelling and immobility will make everyone worry. Spasms, asymmetry, weakness and swelling of the facial muscles may indicate such a common disease as facial neuritis. The disease has an abrupt onset and, in the absence of proper treatment, serious consequences - in the advanced form of the disease, nerve fibers die and it is difficult to restore normal motor function of the face. Let's take a closer look at this disease, its causes, symptoms and the possibility of treatment at home.

Facial neuritis: causes of the disease

Neuritis of the facial nerve is often a unilateral inflammation of the facial nerve responsible for movement and facial expressions, which results in pain in the affected area, inability to control facial muscles, and facial asymmetry. The causes of the disease consist of a number of provoking factors:

Main symptoms

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The disease develops rapidly. Neuritis of the facial nerve is divided into primary (occurring for the first time due to hypothermia) and secondary (attached against the background of concomitant diseases). Depending on the degree of damage, the following symptoms appear:

Later, characteristic asymmetry of the face appears, protrusion of the eye, inability to close the eye or raise the eyebrow. Eating becomes difficult, taste buds are disrupted. Hearing becomes more acute, all sounds seem unbearably loud.

Diagnosis methods

If symptoms of neuritis are detected, you should consult a neurologist. After examination, it will not be difficult for an experienced specialist to make a diagnosis and determine the location of the lesion of the facial nerve.

However, if we are not talking about primary neuritis, additional studies will be ordered to determine the cause:

• a blood test showing the presence of a bacterial inflammatory process;
• magnetic resonance imaging (detects tumors and inflammation of the brain, ischemic diseases);
• computed tomography (determines signs of a micro-stroke, consequences of a head injury - brain hematomas).

To determine the extent of nerve damage, electroneurography and electromyography are prescribed. Consultation with an otolaryngologist or dentist may be recommended.

Therapy for neuritis

Depending on the degree of damage and the cause of the disease, complex treatment is prescribed. With timely treatment, the prognosis for recovery is good; relapses of the disease occur in 10% of cases. In another 10% of patients, the motor functions of the facial muscles cannot be restored. Comprehensive treatment is the key to successful recovery.

Medicines

When diagnosing a secondary form of neuritis, its cause is treated first. In the primary form, treatment is carried out both in the hospital and at home, strictly under the supervision of a doctor. In the acute period, medications are first prescribed to relieve pain, swelling and inflammation. Additionally, sedatives are prescribed.

Group of medicines	Names of drugs	Action
Diuretics	Trifas, Furosemide, Lasix	Removes fluid from tissues, which helps reduce swelling and avoid compression of blood vessels
Nonsteroidal anti-inflammatory drugs	Nurofen, Mig-400, Nimesil	Relieves pain and inflammation of nerve fibers
Glucocorticosteroids	Prednisone, Hydrocortisone	Relieves swelling, pain and inflammation, relaxes muscles
Antispasmodics	No-shpa, Spazmalgon	Relaxes smooth muscles, promotes dilation of arteries
Neurotropic drugs	Carbamazepine, Finlepsin, Neuralgin	Relaxes muscles, relieves nervous tics
B vitamins	Neurobion, Neurobex, Neuromultivit	Improves the functioning of the nervous system

Gymnastics and massage

After the acute condition is relieved, it is necessary to begin performing special gymnastics and a course of massage. They can be carried out at home.

It is necessary to start a complex of special gymnastics after exercises that warm up the muscles of the neck and shoulder girdle. To do this, perform circular movements with your shoulders, turns and bends of your neck with a small amplitude. It is better to perform the movements while sitting with a straight back. After warming up, facial gymnastics is performed:

Massage increases the effectiveness of gymnastics; it is better to carry it out after performing facial gymnastics. For safety, it is better to entrust this process to a specialist; if this is not possible, do it yourself. Benefits of massage:

• the conductivity of the facial nerve improves, swelling and congestion in the canals decreases;
• by improving the condition of the lymphatic system and the circulatory system, the functions of facial muscles are restored.

You should massage your neck, collar area and face. Perform alternately stroking, kneading, pressing and rubbing actions. Start with the forearm and back of the neck, move to the occipital area and side of the neck, and end the session with a facial massage.

Pay special attention to facial massage. Perform with caution:

Acupuncture

A proven effective method of treating neuritis is acupuncture. To ensure the effectiveness of the procedure, certain rules are followed:

• start acupuncture after pain and swelling are relieved;
• do not combine with other physiotherapy procedures;
• exclude painkillers;
• Perform acupuncture an hour after meals.

The procedure involves inserting medical needles into active biological points. This helps to activate the body's own defenses. The method is painless, a slight tingling and warmth is felt at the injection site. Sessions are carried out on both the healthy and the affected side. It will take 10-15 sessions, you can repeat the procedure in a month.

Treatment of neuritis with folk remedies

Assessing the severity of the diagnosis and after consulting with a doctor, treatment of neuritis can be supplemented with folk remedies at home. Traditional medicine recommends using fir oil when performing a massage and adding dates to your diet.

There are a large number of traditional medicine recipes that help overcome the disease. For this, herbs, tinctures, and bee products are used.

Warming up with salt and sand

The inflamed facial nerve loves exposure to heat. Home heating with salt and sand will help replace ultra-high frequency therapy (UHF) carried out in hospitals.

To do this, heat table salt or sand in a dry frying pan and place them in a bag made of natural fabric (a sock will do). Apply to the affected side of the face for 30 minutes at least twice a day. After warming up, cold and drafts should be avoided.

Artemisia applications

A wormwood compress is considered an effective folk remedy for relieving nerve inflammation. To do this, fresh or dry wormwood grass is crushed and mixed with a small amount of boiling water to form a paste. Add a teaspoon of sea buckthorn oil to the mixture. Apply warmly to the sore spot, covering the top with thick polyethylene and wrapping it in a woolen scarf. Keep the application until the mixture cools completely.

Honey based masks

The healing properties of honey are also used to treat neuritis. The simple composition of the product allows you to successfully use this mask: mix a tablespoon of honey with freshly squeezed onion juice, add beaten egg white to the resulting mixture and mix gently. Apply the mixture to a strip of cloth and apply to your face for 40-60 minutes.

Special mustard plasters are also prepared from honey. Mix honey, propolis tincture and any oil in equal parts. Apply the mixture to gauze, apply to your face and cover with mustard plaster on top of the gauze. Keep for no more than 15 minutes.

Herbal tinctures

A complex mixture of pharmaceutical tinctures has long proven itself in the successful treatment of heart disorders and nervous tension. It will not be superfluous in the treatment of neuritis, as it has a calming and relaxing effect.

Mix tinctures of peony, hawthorn, motherwort, and valerian in equal quantities, add half a bottle of Corvalol (15 ml) to the mixture. Take a teaspoon 30 minutes before bedtime for three months.

Disease prevention

Prevention of the disease includes a set of measures to support general immunity:

• consult a doctor in a timely manner so as not to miss severe infectious diseases;
• choose a qualified dentist and visit him once every six months for preventive purposes;
• avoid hypothermia and drafts, especially during colds;
• eat rationally, take a complex of essential vitamins and microelements and limit alcohol consumption;
• Avoid stress and anxiety; if you have aching pain in your heart, consult a cardiologist.

To avoid relapse of the disease, treatment of primary neuritis should be comprehensive and carried out under the supervision of a physician (see also:). Do not self-medicate without being completely sure of the correct diagnosis.

Facial neuritis is an inflammation of one of the 7 pairs of cranial nerves. As a result, a person cannot normally control his own face and express emotions. It looks skewed and asymmetrical.

It is worth considering that this disease occurs quite often, especially in the cold season. To restore the function of your facial muscles, you need to see a doctor as soon as possible.

Anatomy

The facial nerve is responsible for the normal functioning of the facial muscles. It also contains fibers of the intermediate nerve, which are involved in the synthesis of tears and saliva. They are also responsible for the sensitivity of the tongue and skin.

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The nerve trunk consists of long processes of neurons that are covered with a sheath. If inflammation affects only the membrane, then the disease has mild symptoms.

The facial nerve includes the following components:

• part of the cerebral cortex - responsible for facial expressions;
• motor fibers of nerve cells;
• nuclei of the facial nerve - responsible for taste buds, facial expressions and the secretion of tears and saliva;
• vessels - blood and lymphatic.

If this nerve becomes inflamed, the volume of its nerve fibers increases. In narrow places this leads to compression and disruption of nerve cells. Neuritis of the facial nerve has its own code according to ICD 10 - G51.0 “Bell's palsy”.

Classification

There are two main types of facial neuritis:

Causes

The reliable reasons for the development of the disease have not yet been established. However, the development of the inflammatory process can be influenced by the following factors:

Mechanism of disease development

Due to the impact of unfavorable factors on the body, arterial spasm occurs. During this process, blood stagnates in the capillaries and their expansion occurs.

The liquid part of the blood accumulates in the spaces between the cells. As a result, the tissues swell, which causes compression of the veins and lymphatic vessels, and this is fraught with problems with the outflow of lymph.

As a result, blood circulation in the nerve suffers and it faces a lack of nutrients.

It is worth noting that nerve cells exhibit increased sensitivity to oxygen deficiency. The nerve trunk increases in size and hemorrhages form in it.

As a result, the transmission of impulses from the brain to muscle tissue is disrupted. This causes the symptoms of the pathology.

Signs and symptoms of facial neuritis

Neuritis of the facial nerve always develops rapidly. If symptoms increase slowly, this indicates the presence of another pathology.

Signs of this disease include the following:

Symptoms of the disease will allow an experienced specialist to identify the specific area of ​​damage to the facial nerve:

Diagnostics

If symptoms of neuritis appear, you should immediately contact a qualified neurologist. An experienced specialist will be able to identify diseases without conducting research.

However, sometimes there is a need to use instrumental methods. With their help, you can determine the causes of inflammation. Neuropathy can be the result of tumor formations, inflammatory processes in the brain, or stroke.

To make an accurate diagnosis, perform:

Treatment

For treatment to be as effective as possible, it must be started as early as possible and be comprehensive.

Medication

The following categories of drugs are used to treat the disease:

Treatment of this disease is carried out under the supervision of the attending physician. Self-administration of medications can cause serious side effects.

Physical procedures

Physiotherapy products can be used only from 7-10 days after the onset of the disease.

For this diagnosis, the following methods are most effective:

• ultraviolet irradiation of half or the entire face;
• decimeter therapy on the affected side of the face;
• ultra-high-frequency therapy of low-thermal intensity;
• electrophoresis of medications - use prozerin, dibazol, potassium, nivalin, vitamin B1;
• diadynamic therapy;
• paraffin or ozokerite applications.

During therapy, it is very important to avoid hypothermia, as it can worsen the condition. After completing the procedure, it is advisable to remain indoors for 15-20 minutes. In cool weather, you should wear a hat and cover the affected area with a scarf.

Massage

This procedure can be started only 5-7 days after the onset of the disease.

A qualified specialist should perform massage for neuritis of the facial nerve, since it has certain features:

1. Before starting the process, you should pay attention to warming up the neck muscles. To do this, tilt and turn the head. All movements should be done 10 times. They need to be done quite slowly and make sure you don’t get dizzy.
2. The massage should begin with the neck and occipital region. This helps prepare the lymphatic vessels as they need to receive additional lymph.
3. Then you need to massage the affected and healthy parts of the head. It is important to pay special attention to the face, cervical spine and mastoid process. You should also be sure to stretch the collar area.
4. The massage should be done superficially, especially at the very beginning. Otherwise, it can provoke painful contractions of muscle tissue.
5. The procedure should be performed with stroking movements. A little vibration will also help achieve excellent results. Such movements should be made in the direction of lymph outflow.
6. You should make movements with your fingers from the middle part of the chin, forehead, nose in the direction of the parotid glands. At the same time, it is forbidden to touch the areas where the lymph nodes are located, as this can provoke inflammation.
7. You can do the following exercise yourself: place your thumb behind your cheek and gently stretch the muscles, while using the thumb and index finger of your second hand to massage the outside of your cheek.
8. After performing a facial massage, you again need to massage your neck and back of the head. This will help normalize the outflow of lymph in the direction of the main ducts.
9. At the end of the procedure, you need to perform exercises for the neck muscles.

The session should last 10-15 minutes. The massage should be performed until the signs of the disease completely disappear. As a rule, a massage therapist performs 10-20 procedures, after which a person can do self-massage.

Folk remedies

Such recipes can be an addition to the main therapy. With their help, you can significantly speed up the healing process.

The most effective folk remedies include the following:

Gymnastics

Before doing exercise therapy, you need to do exercises to warm up the muscles of the cervical and shoulder areas. Then you need to sit in front of the mirror and try to relax.

For rehabilitation to be successful, each exercise is performed 5-6 times. To do this you need:

• raise your eyebrows in surprise;
• frown;
• look down and close your eyes;
• squint;
• perform circular movements with your eyes;
• smile without opening your teeth;
• raise your upper lip, opening your teeth;
• lower your lower lip, showing your teeth;
• smile with your mouth wide open;
• lower your head and snort;
• flare your nostrils;
• puff out your cheeks;
• move air between the cheeks;
• blow out an imaginary candle;
• try to whistle;
• pull in the cheeks;
• stretch your lips into a tube;
• lower the corners of the mouth;
• place your upper lip on your lower lip;
• move your tongue in different directions, closing and opening your mouth.

If you are tired, you need to pause and stroke your face. This exercise should last about 20-30 minutes. It must be performed 2-3 times a day - this will significantly speed up recovery and help cure even advanced neuritis.

After performing the exercises, you need to secure your face with a scarf folded diagonally. Then pull the muscles on the sore side up, and on the healthy side, point them down.

Acupuncture

This method is one of the most effective in the development of neuritis of the facial nerve.

Acupuncture allows you to:

• eliminate the inflammatory process;
• relieve pain;
• speed up the process of eliminating paralysis of facial muscles;
• cope with lip or eye twitching.

By influencing acupuncture points, you can restore the tone of muscle tissue on the affected side and relax it on the healthy side. This allows you to make your face symmetrical.

For treatment to be effective, you need to contact a qualified specialist who will select the optimal technique. The patient’s internal mood is also important.

When punctured, a person feels slight pain, then warmth or coolness, tingling, and pressure will be felt around the needles. Such sensations indicate that impacts are being made in the right places.

At the first symptoms of the disease, the procedure is performed exclusively on the healthy side. From 5-7 days you can influence the affected area. With this procedure it will be possible to speed up the healing process by approximately half.

Operation

If conservative treatment methods do not produce results within 8-10 months, there is a need for surgical intervention. It will give the desired results only during the first year of the disease, after which irreversible changes occur in the muscles.

In most cases, intervention is required for ischemic neuritis, when compression of the nerve occurs in a narrow canal. This may be a consequence of prolonged inflammation of the ear or a fracture of the cranial bones. Surgery is also needed in case of traumatic origin of neuritis, when a nerve rupture occurs as a result of damage.

If the neuritis is a consequence of nerve compression, a semicircular incision is made behind the auricle. The wall of the nerve canal is removed using a special instrument.

This must be done extremely carefully so as not to damage the nerve trunk. As a result, it is placed in an open groove, due to which the compression by the temporal bone stops. This intervention is performed under general anesthesia.

If there is a need to stitch the nerve, an incision is made in the area of ​​the auricle. After which the doctor finds the ends of the nerve and cleans the torn area - this will ensure better fusion.

If the distance between the ends of the nerve is no more than 3 mm, they are sutured. If this distance exceeds 12 mm, there is a need to free the nerve from nearby tissues and lay a new channel. This procedure allows you to connect the nerve with one suture, but its blood circulation suffers.

It is also possible to restore the integrity of the nerve using an autograft. In this case, a part of the nerve of the required length is taken from the thigh and placed at the site of the rupture.

This allows you to restore a part of the nerve that is several centimeters long. However, there is a need to stitch the nerve in 2 places, which leads to disruption of signal transmission.

Consequences

After neuritis, the process of cell recovery occurs extremely slowly. During this period, they are highly sensitive to hypothermia, stressful situations and the effects of toxic substances.

If you do not follow all the doctor’s instructions, neuritis can lead to dangerous consequences:

Neuritis is an inflammation of peripheral nerve fibers.

A very severe, sometimes irreversible and aesthetically traumatic disease is facial neuritis. In which, there is a unilateral complete or partial loss of facial facial activity.

The disease does not depend on gender or age. Most often, pathological changes appear in the cold season due to hypothermia.

What it is?

In total, a person has XII pairs of cranial nerves, which contain their central nuclei in the brain, and a peripheral network in different parts of the head. Each pair performs only its own functions and innervation.

VII pair - the facial nerve innervates the muscles involved in facial expressions - the orbicularis oris muscle, the occipital group, the stylohyoid muscle, the digastric muscle (posterior belly), and the subcutaneous muscle of the neck. The motor nuclei of this cranial pair are located near the medulla oblongata. The anatomical structure of the facial nerve is very complex. The path from the nerve nuclei to the muscles is very tortuous and passes through various anatomical structures of the head.

Causes

The facial nerve (there are two of them: left and right), after leaving the brain, passes through the canal of the temporal bone in the cranial cavity.

It enters the face through a special hole in the temporal bone and here it innervates (connects with the central nervous system) the facial muscles that provide facial expressions. In addition, the nerve contains fibers that provide lacrimation, salivation, a sense of taste in the anterior two-thirds of the tongue, and hearing. All of these functions may be affected together or in part depending on the level of nerve damage along the way. Like most neurological diseases, facial neuritis does not have one cause.

The culprits for its development may be:

• tumors;
• meningitis, encephalitis, arachnoiditis;
• diffuse connective tissue diseases (systemic lupus erythematosus, scleroderma, periarteritis nodosa, dermato- and polymyositis - so-called collagenoses);
• metabolic disorders (diabetes mellitus, for example);
• Guiena-Barre polyradiculoneuropathy;
• acute cerebral circulatory disorders;
• viral infections: herpes simplex, influenza, mumps, Epstein-Barr viruses, adenoviruses;
• bacterial infections: syphilis, brucellosis, leptospirosis, borreliosis, diphtheria, etc.;
• inflammatory diseases of the ear (in the area of ​​the outer, middle and inner ear - otitis media, mesotympanitis);
• congenital anatomical narrowness of the facial nerve canal;
• fractures of the base of the skull with damage to the temporal bone, surgical interventions in this area;
• multiple sclerosis.

Factors that provoke the disease include hypothermia of the face (especially in the form of a draft - traveling in a car with an open window, air conditioning), pregnancy (due to the development of edema, the channel for the facial nerve becomes narrow).

Development of neuritis

The mechanism of facial nerve development is based on dysfunction in the nerves. Tumors, trauma, and infections gradually destroy myelin and lemmocytes involved in transmitting impulses along the fibers; in complex cases, the axial cylinder is destroyed. As a result, the transmission of impulses from the brain to tissues is disrupted in nerve fibers, which then cease to function.

The most common form of facial paralysis, which occurs as a result of acute neuritis or neuropathy, is idiopathic - Bell's syndrome (or Bell's palsy). The pathology develops sharply. First, uncharacteristic pain behind the ear appears, and after 2-3 days the facial muscles weaken.

Bell's palsy occurs in several stages:

• gradual increase in symptoms (from 48 hours to 8 days), the appearance of edema, ischemia, pinched nerve;
• early recovery – up to 1 month – return to the previous functionality of the facial muscles and elimination of swelling of the fibers;
• late recovery (from 3 to 4 months) – disturbances in the facial muscles are restored slowly and not completely, which indicates severe changes in the facial nerve;
• the final stage, which is characterized by residual signs of paralysis - atrophy of facial muscles, involuntary movements of facial fragments (tip of the mouth, eye).

Bell's palsy is most often unilateral; less common is bilateral pathology, which is a consequence of a more serious disease.

Symptoms of facial neuritis

Neuritis of the facial nerve always develops acutely. Before the full development of clinical manifestations, the patient may experience pain behind the ear, radiating to the face, back of the head, or orbit (the beginning of nerve swelling). The inability of the brain to control the facial muscles on the side of the nerve lesion gradually develops.

The patient has:

• mask-like face on the painful side and loss of symmetry;
• frequent biting of the patient's cheek while eating;
• dry mouth is a consequence of a violation of the innervation of the salivary gland, or vice versa - profuse drooling from the drooping corner of the mouth;
• problems with speech - slurring, especially when trying to pronounce sounds - “p”, “b”, “v”, “f”;
• dry eye, rare blinking and inability to close the eye on the painful side, drying out and inflammation of the mucous membrane. Some people complain of excessive tearing;
• wide opening of the eye, drooping of the corner of the mouth, smoothing of the nasolabial fold. These signs especially appear when talking, trying to laugh, or when crying;
• pouring liquid food from the corner of the mouth;
• loss of taste on the anterior surface of the affected half of the tongue;
• increased sensitivity to sounds on the painful side (due to the proximity of the nuclei of the facial and auditory nerves.) Sounds seem louder to the patient, especially low ones.

Based on existing complaints and symptoms, an experienced neurologist can suggest the location of the lesion of the facial nerve.

Diagnostics

Diagnosis of neuritis of the facial nerve is carried out on the basis of:

1. Complaints and medical history, objective examination of the face and assessment of its symmetry at rest and during articulation and an attempt to smile.
2. Special diagnostic tests for neuritis of the facial nerve: closing the eyes simultaneously and alternately, squinting the eyes, moving the eyebrows (symmetrically and asymmetrically), an attempt to frown the nose and eyebrows, and purse the lips into a tube.
3. Checking the taste and temperature sensitivity of the tongue (dysgeusia) - a violation of the differentiation of salty and sweet, only the sensation of bitter remains unchanged.
4. Identification of pathological symptoms of neuritis of the facial nerve:
   • An unpleasant and immediately noticeable sign is Bell's symptom - an upward rotation of the eyeball when trying to close the eyes. As a result, the following symptom becomes noticeable - lagophthalmos or “hare's eye”, this is a gaping of the white area of ​​​​the sclera of the eye.
   • Revillot's sign is eyelid dyskinesia that occurs when trying to close the eyes. On the healthy side, the eye remains slightly open due to lack of control over the orbicularis oculi muscle.
   • Symptom of sailing - when you try to take air into your mouth and close your lips tightly, blow out a candle or whistle, the air whistles out of the paralyzed corner of the mouth, and the cheek “sails” at the same time.
   • “Racket” symptom – when you try to bare your teeth, their exposure occurs only on the healthy side, as a result of which the mouth gap takes the form of a lying tennis racket.
   • Convergent strabismus in strokes.
   • Horizontal nystagmus in Hunt's syndrome.
5. Instrumental research methods are used for neuritis of the facial nerve for etiological purposes: computed tomography or magnetic resonance imaging.
6. Electroneuromyography is used to determine the localization of the inflammatory area.

Complications

If you start treatment for facial neuritis or ignore the doctor’s recommendations, the consequences can be serious:

• synkinesis - friendly movements. Due to the disease, some of the nerve fibers die. Therefore, one nerve can control many muscles. Yes, when
• when blinking, the corner of the mouth may rise;
• muscle atrophy - can occur due to impaired innervation of muscles and their inactivity;
• conjunctivitis - develops due to the inability to completely close the eyes;
• spontaneous contraction of facial muscles;
• muscle contracture - tightening of the facial muscles on the affected side of the face.

Treatment of neuritis of the facial nerve

Treatment of inflammation of the facial nerve is aimed at increasing blood supply and lymphatic drainage in the face and neck, normalizing the conduction of nerve impulses and restoring the functioning of damaged muscles. The most favorable time to start therapy is the first three days from the onset of symptoms.

If treatment is started later, the chances of a favorable outcome are reduced.

Drug treatment

Acute neuritis is treated with several groups of drugs at once.

1. Glucocorticosteroids and non-steroidal anti-inflammatory drugs - injections of Prednisolone, Dexamethasone, Meloxicam, Nimesulide, Piroxicam - reduce inflammation and help suppress pathogenic processes in the body.
2. Antibiotics - Amoxicillin, Tetracycline - inhibit the development of bacterial infection.
3. Vasodilators - Eufillin, nicotinic acid, Complamin - stimulate blood circulation in the affected area.
4. Diuretic tablets - Torasemide, Furasemide - reduce swelling.
5. Analgesics and antispasmodics - Analgin, Solpadeine, Drotaverine, Spazmolgon - relieve pain and reduce spasms.
6. Neurometabolic drugs - Espalipon, Berlition, thiogamma - improve recovery processes in the affected muscles.

To combat the herpes virus, which caused inflammation of the facial nerve, antiviral drugs are used - Acyclovir, Valacyclovir. In order to improve metabolic processes in nerve fiber tissues, preparations with B vitamins are used.

Pain relief

In order to relieve pain due to inflammation of the facial nerve, you can use strong anticonvulsants, for example, carbamazepine. The dose of the drug is selected individually by the doctor and after two days patients notice a decrease in pain.

Sometimes you have to take carbamazepine for quite a long time (up to six months) until the patient notices a decrease in the severity of pain.

Massage for neuritis

You can start doing massage for facial neuritis 5-7 days after the first symptoms of the disease appear. It is better to entrust this to an experienced specialist, because massage has some peculiarities.

1. Before the massage, you need to stretch your neck muscles. To do this, tilt the head back and forth, turn and rotate the head. All exercises are performed 10 times at a very slow pace. Be careful not to get dizzy.
2. Begin the massage from the back of the head and neck. In this way, the lymphatic vessels are prepared, because they must receive an additional portion of lymph from the facial part of the head.
3. Massage the sore and healthy side of the head.
4. Particular attention is paid to the face, mastoid process and neck. The collar area is also kneaded.
5. Facial massage should be superficial, especially in the first days. Otherwise, painful muscle contractions may occur.
6. Massage with stroking movements; light vibration gives a good effect.
7. Movements are performed along the lymph outflow lines.
8. Run your fingers from the middle of the chin, nose and forehead to the parotid glands. Repeat this movement many times.
9. Do not massage areas where lymph nodes are located. This can cause them to become inflamed.
10. Do this exercise yourself. The thumb of one hand is tucked behind the cheek and the muscles are easily stretched. Using the thumb and forefinger of the other hand, massage the muscles of the cheek from the outside.
11. After the facial massage, the muscles of the back of the head and neck are massaged again to improve the outflow of lymph to the main ducts.
12. The massage session ends with exercises for the neck muscles.

The duration of the massage session is 10-15 minutes. It is necessary to do a massage until the symptoms disappear completely. Usually a massage therapist conducts 10-20 sessions, and in the future you can do self-massage using the same technique.

Physiotherapy

Gymnastics for facial neuritis is done several times a day for 20-30 minutes. It should be done in front of a mirror, concentrating on the work of the facial muscles of the affected side. When performing exercises, it is necessary to hold the muscles on the healthy half of the face with your hand, since otherwise they can “pull” the entire load onto themselves.

A set of exercises for facial neuritis:

1. Close your eyes tightly for 10-15 seconds.
2. Raise your upper eyelids and eyebrows up as much as possible and hold the position for a few seconds.
3. Slowly frown your eyebrows and hold this position for a few seconds.
4. Try to slowly inflate the wings of your nose.
5. Slowly inhale air through your nose, while placing your fingers on the wings of your nose and pressing on them, resisting the air flow.
6. Smile as widely as possible, try to make your molars visible when smiling.
7. Smile widely with your mouth closed and lips closed, making the sound “i”.
8. Place a small walnut behind the cheek on the affected side and try to talk like that.
9. Puff out your cheeks and hold your breath for 15 seconds.
10. Curl your tongue, cover your lips, and slowly inhale and exhale through your mouth.
11. Move your tongue between your cheek and teeth in a circle.

Hirudotherapy

Treatment of facial neuritis with leeches is gaining increasing popularity. The healing effect is observed due to the properties of leech saliva: it restores the necessary nutrition of tissues, dilates blood vessels, and relieves pain. Thus, the use of hirudotherapy for neuritis gives:

• relieving inflammation;
• pain reduction;
• improvement of vascular function;
• strengthening the immune system;
• removal of edema.

Leeches are placed along the inflamed nerve. 4–6 individuals are used at a time, depending on the affected area. Such treatment must be agreed with your doctor.

Traditional methods

At home, you can try folk remedies as auxiliaries if you are treating with medication a nerve that has caught a cold:

1. Warm the sore spots with 200 g of hot salt or sand. To do this, heat the substance in a frying pan without oil, place it in a fabric bag and keep it on the affected areas for at least half an hour;
2. Drink chamomile tea and make compresses from the remaining tea bags;
3. Drink rose petal tea. 3 tbsp. dry matter, pour a glass of boiling water, let the tea brew and take a glass three times a day for a month;
4. Prepare a healing ointment from black poplar buds. You will need 2 tbsp. dry or fresh substance and the same amount of butter. Mix the ingredients and apply the resulting ointment to sore areas after warming with salt once a day. The duration of therapy is a month.

Operation

If conservative treatment methods do not produce results within 8-10 months, there is a need for surgical intervention. It will give the desired results only during the first year of the disease, after which irreversible changes occur in the muscles.

In most cases, intervention is required for ischemic neuritis, when compression of the nerve occurs in a narrow canal. This may be a consequence of prolonged inflammation of the ear or a fracture of the cranial bones. Surgery is also needed in case of traumatic origin of neuritis, when a nerve rupture occurs as a result of damage.

If the neuritis is a consequence of nerve compression, a semicircular incision is made behind the auricle. The wall of the nerve canal is removed using a special instrument.

This must be done extremely carefully so as not to damage the nerve trunk. As a result, it is placed in an open groove, due to which the compression by the temporal bone stops. This intervention is performed under general anesthesia.

If there is a need to stitch the nerve, an incision is made in the area of ​​the auricle. After which the doctor finds the ends of the nerve and cleans the torn area - this will ensure better fusion.

If the distance between the ends of the nerve is no more than 3 mm, they are sutured. If this distance exceeds 12 mm, there is a need to free the nerve from nearby tissues and lay a new channel. This procedure allows you to connect the nerve with one suture, but its blood circulation suffers.

It is also possible to restore the integrity of the nerve using an autograft. In this case, a part of the nerve of the required length is taken from the thigh and placed at the site of the rupture.

This allows you to restore a part of the nerve that is several centimeters long. However, there is a need to stitch the nerve in 2 places, which leads to disruption of signal transmission.

Prevention

It is possible to prevent diseases of the facial nerve by following simple rules:

• avoid hypothermia, exposure to drafts;
• monitor the condition of your teeth;
• promptly treat colds, infections, systemic diseases;
• avoid injuries, nervous strain, stressful situations;
• lead a healthy active lifestyle;
• avoid excess weight;
• engage in physical education and sports;
• to refuse from bad habits;
• eat right, take vitamins periodically.

If you suspect nerve damage, you should immediately contact a specialist.

Course and prognosis

The prognosis of this disease in most patients is favorable - complete recovery is observed in 75% of patients. If facial muscle paralysis persists for more than 3 months, the patient's chances of a full recovery rapidly decrease.

If neuritis is caused by injury or disease of the hearing organ, restoration of normal muscle function may not occur at all. As for recurrent neuritis, each subsequent episode of the disease is somewhat more severe than the previous one, and the recovery period lengthens.

Facial neuritis (Bell's palsy) is an inflammatory process that involves one of the seven pairs of cranial nerves. In this case, clear visible manifestations are observed that distort and distort the patient’s face. Moreover, the affected side gets out of control, facial expressions suffer. Thus, a sick person cannot frown, move his eyebrow, or even smile normally. In addition, it is impossible to close the eye tightly, chew food normally, and even partially feel the taste.

The course of the disease manifests itself in a pronounced and visible form to others, which adds psychological suffering. In general, the reason for such a clinical picture during inflammation is associated with the passage of the nerve through the narrow canals of the facial bones. So that even minor inflammation leads to compression. As a rule, the inflammatory process affects one side, but in exceptional cases, which account for about 2.5%, bilateral damage occurs.

In general, neuritis of the facial nerve is a fairly common disease, which occurs with a frequency of one case per 4,000 people. The time of risk is the cold season. Very often, a surge in incidence is associated with temperature fluctuations in a given area and a general decrease in people’s immunity.

Neuritis is a disease that is protracted. You will have to stay in hospital for about a month, and for a complete recovery it may take a whole six months. But, unfortunately, such paralysis is prone to relapse in more than 10% of common cases. The general condition and prognosis depend on how deeply the nerve is damaged, whether single or bilateral damage is observed, as well as the fact how quickly and comprehensively the treatment was started.

The facial nerve itself undergoes a number of bends and overcomes a large number of small holes. Thus, it passes through the temporal bone, the internal auditory canal and the parotid gland.

When inflamed, the nerve swells and becomes pinched in these small passages, which entails all the obvious symptoms that characterize this disease.

Why does the facial nerve become inflamed?

The causes of the inflammatory process can be many factors. Let's look at the most common ones.

1. Specific viruses. Many viruses, when they enter the body, do not manifest themselves at first. But, under favorable conditions, their active reproduction occurs. The virus that is one of the main culprits of neuritis is, known to many, the herpes virus. In addition, it is believed that mumps viruses, polio, and some others can also be causative agents.
2. Unfavourable conditions. It has been observed that the highest number of cases is in the northern regions. Local and constant general hypothermia leads to decreased immunity, vascular spasms and changes in the nutrition of tissues and the nerves themselves, thus provoking clinical manifestations of neuritis.
3. Constant and large doses of alcohol. Alas, alcohol addiction and the intoxication caused by it have a detrimental effect on many systems and organs. Nerves are no exception. In this way, inflammation is provoked. Moreover, as a rule, such patients arrive with already advanced cases and are not inclined to painstaking therapy.
4. Hypertension. Changes in pressure, hemorrhages - all this affects the trophism, therefore, can lead to compression and neuritis.
5. Pregnancy. Hormonal changes have a strong impact on the entire body, and on the nervous system in particular. Therefore, disorders may occur that can cause an inflammatory process.
6. Some traumatic brain and ear injuries. When injured, rupture of nerve fibers and swelling can occur, and as a result, an inflammatory process that already covers most of the nerve.
7. Otitis, sinusitis, unsuccessful dental intervention. All this can contribute to the spread of inflammation to nearby tissues, which can cause compression of the nerve.
8. Stress, depression, long-term chronic diseases. All this can undermine the overall strength of the body.
9. Neoplasms. They are capable of both involving the nerve itself in the inflammatory process, and simply mechanically influencing it, causing compression and changes in nutrition.
10. Multiple sclerosis and atherosclerosis. They affect the condition and integrity of the nerve itself and can cause its changes and inflammation.
11. Diabetes. Affects the general condition of the body and contributes to the occurrence of inflammation.

Symptoms and diagnosis

Neuritis always begins acutely and is characterized by:

• pain behind the ear, radiating to the back of the head or face, the sensation can also spread to the eye;
• there is a distortion of the face, the muscles do not control the affected side;
• the eye of the affected side does not close tightly, forming a gap through which the white is visible, which is called the “hare’s eye”;
• the corner of the mouth on the affected side droops, liquid food partially spills out because of this;
• the full ability to chew food is impaired, although the jaws are under control, food falls behind the cheek, and the patient constantly bites it;
• signals entering the brain from the salivary gland are distorted, so a constant feeling of thirst, increased salivation, and flow of the resulting saliva from the uncontrolled side may occur;
• uncontrollability of the cheek leads to unclear speech;
• tear production changes: the eye may dry out or, conversely, too many tears are produced and they constantly flow from the uncontrolled side;
• part of the tongue on the affected side ceases to sense taste;
• There may be increased irritability to loud sounds and the perception of some everyday and previously familiar sounds as loud and annoying.

To suspect a disease, it is worth carrying out simple manipulations:

• frown;
• puff out your cheeks;
• take water into your mouth;
• smile symmetrically;
• raise eyebrows in surprise;
• wrinkle your forehead and nose;
• blink alternately;
• Close both eyes tightly (assessed by another person).

If, while performing these tasks, you notice that one side of your face falls out of the process and is not under your control, consult a doctor immediately.

If the clinical picture is less clear or for additional confirmation, various studies may be prescribed, for example, electroneurography and electromyography. The essence of the research is to detect distorted transmission of nerve impulses (its decrease or absence). In this way, the diagnosis is clarified, it is assumed which area is inflamed and how severe and extensive the inflammation is.

Treatment

Drug therapy

It is worth noting that treatment should be prescribed exclusively by the attending physician, taking into account the characteristics of your case. Self-medication can lead to disastrous and irreversible consequences. This is just a general diagram.

1. Diuretics remove excess fluid, relieving the nerve from severe pressure.
2. Non-steroidal anti-inflammatory drugs, as the name suggests, relieve inflammation and reduce pain.
3. Glucocorticoids relieve inflammation and pain, but most importantly, they prevent the formation of contracture (tightening of the facial muscles).
4. Antiviral drugs stop the virus from dividing.
5. Antispasmodics reduce spasms, improve nutrition and blood circulation, and reduce pain.
6. Neurotropic agents improve the functioning of nerve cells, reduce tics and contractions, and relieve pain.
7. B vitamins play a major role in the normal functioning of the nervous system, helping it cope with toxins and recover.
8. Anticholinesterase drugs normalize the function of the salivary and lacrimal glands and improve signal transmission.

Physiotherapy and massage

However, drug treatment must be combined with physiotherapy and massage. Massage should begin on days 5-7, and physiotherapy - no earlier than on the seventh day of the onset of the disease. Remember that with these types of therapy you should avoid hypothermia in general and especially in the first 20 minutes after using it. If the disease occurs in the autumn-winter period or early spring, be sure to wrap the affected side in a scarf or hood. It is advisable to avoid walking, and for the first fifteen minutes after the session you should not go outside at all.

Some of the most common physiotherapy procedures are:

• • UHF, which helps improve tissue trophism and reduce inflammation by increasing the number of leukocytes;
  • UV, which promotes the production of immunoglobulins, reducing pain and inflammation;
  • UHF, which increases the temperature in the affected area, dilates blood vessels, restores blood circulation and restores impaired nerve function;
  • electrophoresis, which has an anti-edematous and analgesic effect, and also helps to introduce medicinal substances into the lesion, achieving their high concentration exactly in the right place;
  • diadynamic therapy, which promotes muscle contraction and a kind of “charging” for better recovery and to avoid complete paralysis or incomplete recovery;

Acupuncture is a separate item. When carried out correctly, this procedure can reduce swelling and improve the patient’s general condition, leading to a speedy recovery. However, it is worth recalling that this manipulation should be carried out exclusively in medical institutions. Beware of acupuncture performed privately without proper permits. In this case, you may encounter the opposite effect and, moreover, have all the consequences of using non-sterile material.

Massage for neuritis is of great importance, as it prevents the development of contracture and muscle atrophy in the affected area. It's better to have it done by a professional. At least for the first sessions until you understand its intricacies. In the future, massage can be done independently.

Begin the massage by warming up the neck muscles. If you carry out the procedure yourself, it is enough to simply tilt your head slowly in all directions. Then they begin to knead the back of the head. After all, the lymph nodes in this area will receive additional lymph that has accumulated in the face area, at the site of swelling. Massage is performed on both the affected and healthy areas. The procedure itself should be superficial to avoid pain from strong muscle contraction. You should not massage the location of the lymph nodes directly. This can provoke too much aggravation of the process. The massage should end in the same way as it began: the back of the head and neck area is massaged. On average, the procedure takes 15 minutes.

You can develop the cheek area yourself: pulling it back, grabbing it with your fingers from the inside. So her sensitivity gradually returns.

Folk remedies

Folk wisdom has accumulated extensive experience in the fight against this disease. But, taking into account the experience of your ancestors, be sure to consult with your doctor to determine how suitable the chosen method is for you. Do not forget that, as a rule, such therapy begins no earlier than a week from the onset of the disease.

The most common means are heating. One of these methods is dry heating using sea/table salt or sand. The idea is that a small amount of this material is heated to a pleasant (not hot, but warm) temperature, placed in a cotton bag and applied to the affected area to warm up. If you take pharmaceutical sea salt, saturated with minerals and natural additives (for example, chamomile or lavender oil), then an additional beneficial effect of the components on the regeneration of the damaged area is achieved.

Chamomile can also be used separately. The pharmaceutical collection (preferably packaged) is brewed in a cup according to the instructions. The broth is drunk, and warm bags are applied to the site of inflammation under the film and insulated on top with a scarf. Application time - 15 minutes. In addition to warming, chamomile has a powerful anti-inflammatory and immunity-boosting effect. In addition, this decoction at night has a slight calming effect. After all, a person often has a hard time experiencing his condition and may not sleep well. If the chamomile is not in a bag, but as a dry product, the contents should be placed in gauze for heating.

Complications due to improper therapy

If therapy is started at the wrong time or is not carried out rationally, the most severe consequences are possible. Such as:

• • • muscle atrophy, which occurs approximately a year after the onset of the disease: the muscles seem to “shrink” from inactivity and, alas, an irreversible process of deformation results;
    • contracture of facial muscles, which can occur approximately one and a half months after the onset of the disease: the muscles “tighten”, shorten, painful pulsation and a peculiar distortion of the face are felt (squinted eye, nasolabial fold becomes clearly visible);
    • involuntary twitching of facial muscles can occur due to incorrect impulses;
    • synkinesia, which is characterized by incorrect transmission of nerve impulses, as a result of which the excitation of one zone can be incorrectly transmitted and spread to others, thus producing, for example, “crocodile tears”, when chewing irritates the lacrimal gland;
    • conjunctivitis or keratitis, which develops due to loose closure of the eye and corresponding drying out.

In exceptional cases, if therapy is unsuccessful in the first 8-10 months of the disease, surgical intervention is possible to prevent irreversible consequences caused by atrophy.
But, it is better to start treatment on time. Also, it is important not to give up. Many patients, seeing that the results do not come so quickly, despair and stop attending physical procedures and doing massages. This is what becomes the turning point, and therapy is delayed. Therefore, it is important to continue all appointments and motivate yourself to recover. And also make every effort to prevent hypothermia in the future and maintain your immunity.