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Neuritis of the facial nerve: symptoms and treatment, prognosis

Perhaps one of the most unpleasant and suddenly encountered problems (and for young girls - and terrible) is neuritis of the facial nerve. As a rule, after waking up on a sunny morning, a person approaches the mirror and realizes that one half of his face does not obey.

Mouth can not whistle, lips do not fold into a tube. When drinking water pours out from one corner of the mouth, the eye does not squeeze it from the same side ... At the same time, there is no pain or precursors of deterioration of health. You can imagine what a “shock” this is for a young girl who was going to go on a date in the evening ...

For consolation, we can say that neuritis of the facial nerve is the only disease that is not accompanied by pain and deterioration of health, in which the attendance to the doctor for obvious reasons is almost 100% on the first day after the discovery of paralysis of the facial muscles.

Even with acute toothache, patients may postpone a visit to the doctor for a few days, but not if they have neuritis of the facial nerve.

Little anatomy

Neuritis of the facial nerve

A lot of nerves come out on a person’s face, and to some extent they are all facial. But only one pair of nerves (as is known, a person possesses a bilateral, or mirror symmetry) is called the facial nerve, the nervus facialis. This nerve is also referred to as the VII pair of cranial nerves.

This nerve never hurts, as it is not sensitive, but purely motor. His task is the innervation of the entire musculature of the face, that is, he creates facial expressions and the expression of human emotions. “Brovki house”, frowning forehead, ironic squint of the eyes - this is the work of the facial nerve.

Squinting of the eyes, stretching the lips with a straw, smiling, pulling of the cheeks is also a function of the facial nerve.

This nerve helps with drinking, finally, it is indispensable for kissing.


Neuritis of the facial nerve - what is it?

Neuritis Facial Nerve Photo

Neuritis Facial Nerve Photo

As you know, medical terminology suffix "- it" assigns inflammatory diseases. Neuritis is a condition in which not only the insulating outer sheath of the nerve fiber (myelin) suffers, but also the axial cylinder itself, through which electrical impulses pass. At the same time, degenerative changes occur in the nerve fiber, which, in some cases, may be irreversible.

Then the nerve control over the muscles will be permanently lost, and the persistent residual (residual) signs in the form of paralysis and paresis (partial paralysis) of the mimic muscles will remain.

On the other hand, the term “neuralgia” means pain along the nerves. There is neuralgia on the face, but the trigeminal nerve or the V pair of cranial nerves is to blame for its occurrence. By mistake, it is sometimes called the “facial nerve neuralgia,” although this is a completely wrong statement.


Neuritis of the facial nerve can be acute, subacute and chronic (with the flow), it can also be unilateral (in 99% of all cases) and bilateral. Unilateral neuritis in typical localization occurs on average in 1 - 2 cases per 10,000 population annually.

Nerve damage on both sides at once and complete paralysis of the facial muscles turns a person’s face into a petrified mask. This case is very rare: a person has a much higher chance of breaking two hands at once, in two places each, than to get bilateral paresis of the facial nerve.

Much more often, neuritis first appears on one side, and then, a few days later, a lesion on the opposite side joins.

This occurs when a significant drop in immunity (for example, in the transition of HIV - infection to AIDS) or improper treatment.


Neuritis of the facial nerve: the causes of its occurrence can be considered very diverse. But the leading mechanism is nerve edema in the narrow channel of the temporal bone, where it passes. After all, if the nerve is surrounded by fiber, the edema spreads out during inflammation, and it does not suffer so much.

And in the case of the occurrence of a nerve in the bony narrow canals, with the development of inflammation and edema, the nerve is subjected to severe compression, which is so strong that the electrical impulses - the commands to the muscles - stop passing through the nerve.

That is why the process develops at night: each of us knows that in the morning a person has a “sleepy” face. This means that in the waking state the head is high above the ground, and to supply blood to the head, the heart needs to exert great force.

At night, during sleep, it is much easier to accumulate water in the face and head, due to the horizontal position of the body. That is why at night all the inflammatory swelling on the face intensifies. The same applies to the structures of the cranial cavity.

For example, for the same reason, persistent head "arching" pain in the morning is characteristic of a significant increase in intracranial pressure.

The main cause of neuritis of the facial nerve, leading to edema and disruption of its function, is the herpes lesion, which is very similar to the bubbly rash in chicken pox (because the pathogens are almost identical), and which appears after hypothermia, like a cold on the lips . In addition to the herpes simplex virus, other neurotropic viruses, such as the flu virus, can be causative agents.

In more rare cases, industrial intoxication (lead, mercury, manganese, thallium) can be the cause. But, unfortunately, most often - it is intoxication with ethyl alcohol and chronic alcoholism.

Symptoms of neuritis of the facial nerve

Symptoms of neuritis of the facial nerve

As a rule, at first a person suffers from a cold or a banal hypothermia, with the development of rhinitis and snot. In that case, if the rash of herpes on the lips appear often, the risk of nerve damage increases significantly. In addition, it may just be hypothermia, for example, when driving in a car with an open window.

After that, in the morning, the person feels some discomfort, and goes to the mirror. As a result, it turns out that:

  • Face asymmetry appeared: the usual folds of skin (nasolabial, folds on the forehead) on one side smoothed out, as after the injection of Botox;
    on the side of the lesion, the circular muscle of the eye (orbicularis oculi) has lost its tone, which is why the palpebral fissure is larger and the eyes have become “different”. The eye on the healthy side seems smaller;
  • On the painful side, the lower lip is bulging;
  • Since the circular muscle of the mouth, as opposed to the circular muscles of the eyes, is common, then the mouth is skewed when trying to smile, grin - the mouth pulls in a healthy direction;
  • The brow does not rise and the cheek is not inflated on the side of the paresis;
  • It also fails to squint, and through the narrow, distorted eye slit one can see a “collapsed” eye without a pupil. Such a "slanting" look was called lagophthalmos, or "hare gaze." This condition, especially at night, can lead to drying of the eyeball and the appearance of keratoconjunctivitis, with redness of the eye, a feeling of pain or a feeling of "sand" in the eye. Therefore, you need to use artificial tears;
    also impossible to whistle;
  • To top it off, on the side of the lesion the mouth does not fit the mug, so when drinking, the liquid is poured onto the clothes;
  • Due to the weakness and decrease in the tone of the buccinator (cheek muscle), the cheek "sails", the food is stuck between the cheek and the mandible branch. To top it off such a cheek is easy to bite, because it is constantly between the teeth.

Diagnosis of neuritis

Probably, the above picture did not leave anyone indifferent. It is for her and put the diagnosis of paresis of the facial nerve. Naturally, this clinical picture should be isolated (that is, not accompanied by other neurological symptoms, for example, dizziness, a fall, paralysis of the arms and legs or meningeal symptoms).

A very important sign is that the doctor finds herpetic vesicles in the external auditory canal (if you move the earlobe downwards and backwards), or behind the ear.

An additional fact indicating the nature of the disease is a reference to a history of hypothermia.

Treatment of neuritis of the facial nerve

The neuritis of the facial nerve is treated by a neuropathologist. But, given the complexity and even the inability to get to the neurologist in the Russian free health care without the "sanction" of the therapist, as well as the inability to take a turn to him in the next two weeks, you need to act yourself.

Treatment of neuritis of the facial nerve

The best option is to urgently go to a well-known private center for a good doctor - a neurologist. No need to spare a thousand rubles for a paid admission.

The treatment of this disease is complex, and consists of several stages:

  1. The most important thing in the paresis of the facial nerve is to urgently begin antiviral therapy (drugs acyclovir, famciclovir, ganciclovir, zovirax) are used in tablets according to the scheme. In addition, it is possible to lubricate the area of ​​the external auditory canal with antiviral cream - this is the most important event that needs to be done as soon as possible: in the first days after the development of symptoms, even in the first hours, possibly before a visit to the doctor.

This is perhaps one of the few cases of self-treatment, which is excusable to perform, given the possibility of the development of residual effects. Indeed, in 3 - 4 days after the onset of neuritis, the effect of antiviral therapy will be much lower, if not zero.

  • To reduce edema, the patient must be prescribed diuretics. It would be enough drugs such as "Veroshpiron" or "Torasemide." Rude and old drugs like “Lasix” (furosemide) are not used;
  • It is necessary to make fixing bandages on the face from narrow strips of plaster, “pulling up” the paralyzed muscles and not letting them hang down;
  • Nonsteroidal anti-inflammatory drugs are widely used to reduce inflammation, for example, Ksefokam, Movalis for several days;
  • The patient should receive vitamins of group B, for example, as part of the drug "Milgamma Compositum", "Kombilipen";
  • Sometimes in the first days, hormones are also prescribed to relieve possible edema (prednisone);
  • Alpha - lipoic acid (Berlition), administered intravenously or intramuscularly, has a good effect;
  • Gymnastics with neuritis of the facial nerve is of great importance. It is clear that it is carried out for the muscles of the healthy side of the face. They need to strain and relax, you need to engage 10 - 15 minutes twice a day. Mimic mimic reactions, pronounce the letters.
    carry out therapeutic massage of the healthy half of the face and the neck and collar zone, then with the transition to the affected side, but using a very gentle and delicate technique;
  • From the very beginning of the disease, the patient should visit the physiotherapy room. Sessions of UHF, acupuncture courses, exposure to a magnetic field are especially shown.

The prognosis and consequences of neuritis

Full recovery after neuritis of the facial nerve, subject to compliance with the regimen and prescriptions, occurs in 60 - 70% of cases. Every fifth patient can develop contracture of the muscles, and then, on the contrary, the face will be drawn to the painful side. Most often this condition occurs if the patient completely ignores the treatment and the visit to the doctor.

There are signs that indicate a possible adverse outcome in which improvement may not occur. It:

  1. Complete paralysis from day one;
  2. The presence of concomitant diabetes,
  3. The appearance of dryness of the eye along with paralysis;
  4. No improvement 21 days after the onset of the disease.

Neuritis of the facial nerve, the symptoms and treatment of which were described above, is a disease reflecting the medical literacy of the population. Only the timely start of treatment, and its usefulness can lead to a cure. Therefore, it is not worth spending time waiting for spontaneous improvement and wandering in the queues of clinics.

We must act quickly: on the first day of the onset of symptoms, all possible measures for recovery should be taken.

2016-11-15 01:07:05
My nera became inflamed and they stung around my neck (((How to be?
2016-11-15 03:59:26
Diana, you need the help of professionals. I also had problems with my neck, smeared with ointments, and kind of relieved pain. But then, as if jammed (((So the doctor not only prescribed the drugs, but also physiotherapy, massage. And their drugs took Neurodiclovitis. This drug helped relieve pain and inflammation, and Neuromultivitis, which I took after neurodiclovit, helped to ensure that the relapse do not come back. So go to the doctor urgently.

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