How and with what to treat inflammation of the facial nerve?

Inflammation of the facial nerve is medically called neuritis. The facial nerve, or, in other words, the trigeminal nerve, is one of the pairs of cranial nerves and received its second name because of the branches, of which there are three. The first two branches have only sensory fibers, and the third has both sensory and motor fibers (provides chewing movements).

Its inflammation (neuralgia) is often diagnosed in older women. It is worth noting that the disease usually affects the right side of the face.

Classification of neuritis of the facial nerve

The classification of neuritis of the facial nerve is based on the etiological factor: primary and secondary forms of pathology are distinguished. The primary form of neuritis occurs after severe hypothermia. The most dangerous is considered local hypothermia, which provokes spasm of muscles and blood vessels, which leads to disruption of nerve nutrition and its further inflammation.

Secondary neuritis of the facial nerve is considered a complication of various diseases and injuries:

• Herpes virus. Decreased immunity activates the herpes virus, which lives in the body of most people. Since the virus is localized primarily in nerve fibers, an inflammatory process and swelling of the facial nerve occurs. In addition to the herpes virus, the disease can also be triggered by the following viruses: mumps, polio, enterovirus and adenovirus.
• Hypertension. The pathology provokes an increase in intracranial pressure, which affects the nuclei of the facial nerve. Hypertension can trigger a stroke. Neuritis of the facial nerve in this case will occur if hemorrhage occurs near it.
• Traumatic brain injury. Due to a strong blow, nerve fibers are injured and ruptured, after which swelling occurs in the damaged area and inflammation begins to cover the entire nerve.
• Atherosclerosis. In this disease, the capillaries that supply the nerve with blood become clogged with fatty plaques. As a result, the nerve starves and its cells die.
• Previous otitis media or sinusitis. Various diseases of the ENT organs, provoked by bacteria and viruses, can spread to surrounding tissues and provoke compression of the facial nerve.

Causes of inflammation of the facial nerve

Pathology can be provoked by two groups of factors: internal and external.

The first includes:

• Compression of a nerve where it exits the skull. The pressure may be caused by a tumor, vascular aneurysm (bag-like bulge), etc.;
• Multiple sclerosis. The pathology is systemic and occurs in a chronic form. Its peculiarity is the damage to the nerve sheaths;
• Disturbance in the supply of nutrients due to the deposition of cholesterol plaques on the walls of blood vessels. Almost always this disease is diagnosed in old age.

The reasons included in the second group may be the following:

1. Hypothermia of the face, often local. As a result, aseptic inflammation develops, that is, without the presence of infection. You can get hypothermic even at home, sitting by a window in a draft;
2. Herpes zoster virus. This type of pathogen belongs to the herpes family. Its characteristic feature is the ability to remain in a latent, passive state for a fairly long period. It is localized in nerve cells, and when exposed to unfavorable factors (such as hypothermia or decreased immune defense) it is activated and begins to rapidly multiply in the fibers, which provokes inflammation;
3. Injuries, for example, closed craniocerebral injuries, blows to the face, etc.

Regardless of what caused the inflammation, the conduction of impulses along the motor fibers of the nerve is disrupted and the impulse of sensory fibers increases, resulting in toothache.

Symptoms of facial neuritis

The symptoms of neuritis of the facial nerve appear gradually, and over time, new symptoms of the pathology appear. At the beginning of the disease, patients are bothered by severe pain near the ear, which appears due to swelling of the nerve. Usually the pain radiates to the face and back of the head, and after a few days it spreads to the eyeball.

A pronounced symptom of the pathology is an asymmetrical face, which on the affected side looks a little like a mask: the eyes are open wide, the nasolabial fold is smoothed, the corner of the mouth is lowered. When talking, crying or laughing, facial asymmetry becomes more pronounced. Patients may not be able to close the eye on the inflamed side. If the patient tries to close his eyes, the eye will not close completely and a small gap will remain through which the protein membrane will be visible.

Another noticeable manifestation of the disease is drooping of the corner of the mouth. The patient retains the ability to chew and move the jaw, but liquid food falls out on one side during eating. The patient is bothered by constant dry mouth, but sometimes the disease is accompanied by profuse salivation. Since half of the mouth does not participate in articulation, speech eventually becomes slurred.

Some patients with neuritis of the facial nerve experience excessive dryness of the eyeball, while others experience increased lacrimation. In both situations, the cause of the pathological condition is a dysfunction of the lacrimal gland. The perception of taste on half of the tongue completely disappears. Patients also note increased hearing sensitivity, as sounds seem much louder to them.

Symptoms and treatment of signs of inflammation of the facial nerve

• This pathology is primarily manifested by unbearable pain. The branches of the nerve contain a fairly large number of both motor and sensory fibers, so pain is the most significant sign of the disease.
• In addition, there are spasms of the masticatory muscles. It is these symptoms that are classic for this disease and very often it is thanks to them that the doctor assumes the presence of inflammation.
• In most patients, pain is localized in the area of ​​innervation of the nerve branches.
• It is paroxysmal in nature, very strong, sometimes it is compared to the so-called sharp lumbago. Usually only one half of the face is affected, the right or left, respectively.
• During an attack, a person tries not to move, freezes, does not speak, otherwise the headache gets worse. Sometimes the patient begins to vigorously rub his cheek.
• The attack, as a rule, lasts several minutes, gradually its symptoms weaken, but later unpleasant aching sensations are observed in the area of ​​the ear, nose and eye on the affected side.
• Spasms of the masticatory muscles are manifested by a sharp contraction of the latter. The person’s face “distorts”, becomes asymmetrical, and it is almost impossible to open the mouth. There is also pain syndrome. The duration of the spasm, as in the first case, is several minutes.
• The peculiarity of attacks, both spasms and pain, is that they occur spontaneously, for no apparent reason, for example, while washing with cool water or while talking or eating. It has been established that their frequent occurrence may be associated with local hypothermia of the skin in the area of ​​the nasolabial triangle, stress and overwork.

Diagnosis of neuritis of the facial nerve

When making a diagnosis, the neurologist is guided by the results of the patient’s examination, his complaints, laboratory and instrumental studies. All these studies are largely aimed at finding out the causes of the disease. To identify the localization of the pathological process and the degree of nerve damage, the doctor prescribes techniques such as electromyography, electroneurography and evoked potentials. A general blood test is required to confirm signs of bacterial inflammation. A positive result may indicate otitis media or meningitis.

A neurologist may also prescribe an MRI and CT scan of the brain to identify pathologies that could trigger the disease: brain tumors or inflammation, stroke or cerebral infarction, consequences of traumatic brain injury. Depending on the results of these studies, the doctor draws up a treatment plan, which may include restoring blood circulation or removing the tumor.

What is dangerous for the facial nerve?

External factors become provocative for the occurrence of lesions of the facial nerve.
This includes being in low temperatures, cold winds, drafts, and running air conditioning. Pathologies of the facial nerve can be the consequences of surgical interventions during the treatment of purulent inflammation in the ear, salivary glands, and in the structures of the mastoid process of the temporal bone. This is facilitated by traumatic brain injuries, inflammation in the middle ear, in the brain and its membranes. Heredity also plays a role in the diagnosis of neuritis.

Neoplasms in nearby tissues are another cause of nerve damage.

Prolonged stress conditions, heavy physical activity, toxic poisoning, decreased immunity are the causative factors of nerve diseases.

Some diseases of internal organs and systems are the main cause of damage to the facial nerve:

• infectious (ARVI, acute respiratory infections, influenza, herpes and neuroinfections, tuberculosis, syphilis);
• diabetes;
• stroke;
• multiple sclerosis.

Any of the factors is important for the occurrence of inflammation of the facial nerve. Neuralgia often appears due to mechanical effects on the nerve at its exit from the canal.

Inflammation of the nerve, its swelling or anatomical narrowing of the canal leads to the fact that the nerve is pinched in it. The main causes of facial neuropathy are severe colds and systemic diseases. The occurrence of nerve paresis (paralysis) is associated with otitis media, injuries and pinching.

Complications of facial neuritis

Nerve cells recover very slowly, which significantly complicates the treatment process. If the doctor chooses an ineffective treatment tactic or the patient abandons it, this can cause serious complications. The patient may experience muscle atrophy - they will weaken and decrease in volume. Atrophy begins to develop a year after the onset of the disease and is irreversible.

An equally serious complication is contracture of the facial muscles - their tightening and loss of elasticity. In this case, the muscles become very painful and pulsate weakly. The patient experiences a muscle spasm, after which they tighten the affected side of the face. Another complication of neuritis is involuntary muscle twitching - a rhythmic contraction of facial muscles that a person cannot control. Conjunctivitis and facial synkinesis are also considered serious consequences of neuritis.

Consequences of facial neuritis

Inflammation not only causes unpleasant symptoms, but also affects the functioning of other organs and systems of the body.

Even one attack can provoke the following consequences:

1. Constant aching pain in the facial area;
2. Impair the sensitivity of the skin in the area of ​​innervation of the nerve (paresthesia - numbness);
3. Lead to facial asymmetry due to disruption of motor fibers;
4. Cause paralysis of the masticatory muscles on the affected side.

The central nervous system can react with anxiety, depression, and panic fear of a recurrence of the attack. These factors affect the quality of life, significantly worsening it.

Drug treatment

Drug therapy for facial neuritis involves the use of the following groups of drugs:

• non-steroidal anti-inflammatory drugs - relieve inflammation, help relieve pain;
• diuretics - accelerate the excretion of urine from the body, due to which the tissues are deprived of edematous fluid, which avoids compression of blood vessels and swelling of the nerve;
• steroidal anti-inflammatory - relieve swelling, inflammation and pain in nerve fibers, activate the production of a neurotransmitter that improves the conduction of impulses along nerve fibers, and also prevent the appearance of contractures;
• antispasmodic - eliminate vascular spasm, improve blood circulation, dilate arteries, reduce pain;
• antiviral - stop the activation of the herpes virus;
• anticholinesterase - promote the transmission of signals along the nerves in the muscles, which normalizes the functioning of the lacrimal and salivary glands;
• B vitamins - reliably protect the nervous system from poisoning by toxins;
• neurotropic - promote the normal functioning of nerve cells, have an analgesic effect, improve the functioning of the nervous system, and reduce nervous tics.

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 big 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.

Physiotherapeutic treatment

Starting from the second week of therapy, the doctor prescribes physiotherapy. If the patient experiences inflammation in the facial nerve and poor circulation, UHF is prescribed. During the procedure, charged particles penetrate the cells, the tissues are heated, their nutrition is improved and swelling is eliminated. The ultraviolet irradiation procedure relieves inflammation and eliminates pain. To dilate blood vessels, improve blood supply and restore impaired nerve functions, decimeter therapy is indicated.

Electrophoresis of medicinal substances has an anti-inflammatory, analgesic and anti-edematous effect. Using this technique, you can inject the necessary medications in high concentrations under the skin directly into the site of inflammation. Diadynamic therapy is indicated for muscle paralysis, nerve fiber damage and contractures. During this procedure, pulsed direct currents penetrate the muscle fibers through the skin, which provoke their contraction. They also accelerate recovery processes in nerve fibers.

Surgery

If the desired results have not been achieved within 8-10 months from the start of drug treatment, doctors turn to surgical treatment of facial neuritis. The operation is indicated only in the first year of the disease, since in the future irreversible changes in the muscles may occur, so it turns out to be ineffective. Indications for surgical treatment are as follows: nerve rupture in case of traumatic neuritis, nerve degeneration, lack of positive effect from conservative treatment.

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.

Prognosis for neuritis of the facial nerve

The prognosis for patients depends on the diseases concomitant with neuritis and the location of inflammation. It is usually possible to achieve complete recovery of the patient. The patient spends at least 20 days in the hospital. After discharge from the hospital, full recovery may take about 3-6 months. In 5% of patients, muscle function is not restored after treatment. This happens if the disease was caused by a traumatic brain injury or tumor. In 10% of cases, a relapse of the disease is possible at the end of treatment.

Prevention of facial neuritis

Neuritis of the facial nerve can be prevented by avoiding hypothermia, especially local hypothermia. Namely, it is advisable not to sit in a vehicle near an open window, not to stay under air conditioning for a long time, and be sure to wear a hat in the cold. Doctors also advise avoiding stress, eating right, and taking vitamins to prevent neuritis. It is also useful to harden yourself, since in this way you can strengthen the body's defenses and reduce sensitivity to hypothermia. To do this, you need to regularly take a contrast shower, each time slightly lowering the water temperature.