Facial paralysis (facial paralysis)
Facial paralysis is facial paralysis . This can originate in the direct impairment of the facial nerve (peripheral facial nerve palsy) or directly in the brain (central facial nerve palsy). One-sided paralysis of the face with loss of facial expressions is typical of facial paralysis.
What is facial paralysis (paralysis of the face)?
Peripheral facial paralysis is due to paralysis of the facial nerve (facial nerve). The facial nerve is the seventh cranial nerve and originates in the brain. It stimulates the zygomatic, eye, cheek, temple, ear, back of the head and lower jaw muscles.
In doing so, it forwards commands to the appropriate muscles and also receives information from them, which it forwards to the brain. When this function is impaired by an infection of the facial nerve or a lesion in the brain, it is called facial nerve palsy.
causes
Direct damage to the facial nerve (peripheral facial paralysis) can be caused by infections with various viruses. These include herpes simplex viruses, herpes zoster viruses, which cause shingles but can also infect the facial nerve, and Lyme disease pathogens.
Other possible causes can be a direct injury to the facial nerve or inflammation of neighboring facial areas such as a middle ear infection. In the majority of cases, the cause of the facial nerve palsy remains unclear and is therefore also referred to as idiopathic facial nerve palsy.
The causes of a central facial paralysis lie directly in the brain and indirectly impair the function of the facial nerve. Triggers can be a brain tumor, stroke or a fractured skull with cerebral hemorrhage after an accident. While peripheral and idiopathic facial palsy usually resolve on their own over time, recovery from central facial palsy depends on healing of indirect triggers in the brain.
Diseases
- skull fracture
When to the doctor?
If signs of paralysis appear on the face, whether on one side or both sides, a visit to the doctor is always necessary. The causes of facial paralysis are very diverse. If numbness, tingling and reduced mobility suddenly appear in one half of the body, a stroke should be considered. Usually one corner of the mouth hangs down significantly. In this case, it is advisable to call an ambulance as soon as possible, because every second counts.
Facial nerve palsy can be visible in parts of the face from the forehead to the chin. Fast GP diagnoses are absolutely necessary to avoid long-lasting damage.
The paralyzed facial muscles can prevent the eyelid from closing properly. The result would be drying out of the retina. Facial paralysis also causes major problems when speaking, chewing and swallowing , especially if there is also a feeling of numbness. Slurred speech, food leaking from the mouth, or bite wounds may occur.
The family doctor interviews the patient in detail and examines the body. This makes it easier to narrow down possible causes. Is it an injury, an ear infection or the result of an insect bite? The cause is not always immediately apparent. Sometimes specialists, such as ENT doctors or neurologists, have to be consulted and additional blood tests have to be carried out. Facial nerve palsy is no joke, and prompt medical diagnosis reduces the likelihood of permanent damage.
symptoms and course
Typical symptoms of facial paralysis (facial paralysis):
- corner of mouth droops
The typical symptoms of facial paralysis are one-sided, incomplete closing of the eyelids (Bell’s phenomenon), impaired speech and word formation because the lips and cheek muscles are weak, and a corner of the mouth that sags on one side.
The entire facial expression is also affected, the forehead can no longer be wrinkled and the nose can no longer be wrinkled. Even a smile is impossible for those affected. Since the masticatory muscles are also affected, eating is also difficult. In addition, the sense of taste is often impaired, sweet and salty can no longer be distinguished. The facial nerve also controls the flow of saliva and tears .
If the facial nerve is paralyzed, saliva can drip from the drooping corner of the mouth without the affected person noticing. The eye on the paralyzed side can also tear more often. The facial nerve runs right next to the auditory nerve in the internal auditory canal. A temporary tinnitus can occur in the case of facial paralysis, in which those affected perceive loud tones and noises from the inner ear.
Diagnose
The symptoms of facial paralysis are obvious. A neurologist or ENT doctor will clarify whether it is a peripheral or central facial paralysis. Serious causes such as external injuries after an accident, a stroke, meningitis or a brain tumor are first ruled out. Computer and magnetic resonance imaging are helpful here, as they can detect possible changes in the facial nerve and in the brain. If an inflammation of the middle ear is also ruled out as a cause, blood tests can provide information about a Lyme infection, TBE or an infection with herpes viruses .
Using electromyography and neurography, doctors can measure the electrical activity of the facial nerve and determine the speed at which nerve impulses are transmitted to the appropriate muscles . If imaging procedures and blood tests remain without findings, it is an idiopathic facial paralysis, the cause of which cannot be determined.
complications
Depending on the severity of a facial paralysis, it sometimes does not heal completely. A possible consequence is that the nerve fibers grow together unfavorably when they are newly formed and unwanted reactions occur. This includes the phenomenon of the so-called crocodile tears. When eating, not only saliva is formed. At the same time, tears flow from the eye on the affected side. Facial twitches and unwanted movements are called synkinesis and sometimes persist for years. For example, one eye closes involuntarily when the patient tries to purse their mouth.
If the one-sided facial paralysis persists, the muscles on the healthy side work all the harder. It comes to the fact that the whole face can warp further and further in the direction of the healthy side. In therapies, therefore, the indirectly affected, non-diseased half of the face is always treated with a detonizing treatment. If an eyelid is unable to close due to paralysis, the eye dries out over time and requires special treatment to prevent vision loss.
treatment and therapy
The therapy of the facial paralysis is aimed at the cause. In the case of peripheral facial paralysis due to infection with the herpes simplex or herpes zoster virus, the antiviral drug aciclovir is prescribed, which allows the viral infection to subside. Antibiotics help with a Lyme disease infection, a middle ear infection or other ear diseases that affect the facial nerve .
If the cause is unclear, but a central facial paralysis has been ruled out, steroid shock therapy with cortisone can also bring relief. For example, steroids help with autoimmune reactions and inflammatory processes with unclear causes.
It is also important to treat the affected eye symptomatically with eye ointment and to train the facial muscles in order to alleviate the symptoms of paralysis. About 80 percent of peripheral and idiopathic facial paralysis heal completely after a few weeks to months.
If it is a central facial paralysis that can be traced back to meningitis, brain tumors, direct injuries to the facial nerve or a stroke, the underlying disease is treated accordingly. In the case of a central facial nerve palsy, the prognosis for the resolution of the symptoms is not quite as good as in the case of peripheral facial nerve palsy.
prevention
Targeted prevention of facial paralysis is not possible due to the large number of possible causes. It is advisable to treat infections with herpes viruses, Lyme disease or ear infections at an early stage so that facial paralysis does not occur in the first place during the course of the disease. At the first sign of incipient facial paralysis, a doctor should be consulted immediately to clarify the causes.
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My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.