Facial nerve Paralysis

Facial nerve Paralysis

Facial paralysis occurs when a person is no longer able to move some or all of the muscles on one side of the face. The facial nerve is the main nerve that innervates the muscles of the face and therefore enables facial expression.

Facial paralysis is almost always caused by:

• Damage or swelling of the facial nerve, which carries signals from the brain to the muscles of the face
• Damage to the area of the brain that sends signals to the muscles of the face

Fortunately, 85% of facial palsy is due to idiopathic palsy (Bell's Palsy). The etiology remains unclear although viral infections have been implicated and it occurs more frequently in pregnant women. The diagnosis of idiopathic paralysis is made by excluding all other causes. Healing occurs automatically within 6 months and usually no neurological signs remain.

Permanent paralysis is primarily due to:

• Injuries and fractures of the temporal bone
• Large facial traumas
• Tumors (neurofibromas, cholesteatomas, brain tumors, tumors  of the parotid gland, etc.) 
• Autoimmune diseases
• Metabolic diseases

Symptoms

• Sudden weakness or paralysis on one side of the face that causes it to droop. This is the main symptom. 
• It may make it hard for you to close the eye on that side of the face.
• Drooling.
• Eye problems, such as excessive tearing or a dry eye.
• Loss of ability to taste.
• Pain in or behind the ear.
• Numbness in the affected side of the face.
• Increased sensitivity to sound.

Treatment

For treatment to be effective it should be started immediately or at the latest within the first three days of symptoms. Treatment includes medication and physical therapy. The medication consists of antibiotics and cortisone. Antibiotics to fight infection and cortisone to reduce the swelling of the nerve and thus the depressurisation. Supplemental vitamins administered to the patient, especially B complex to strengthen the nerve and eye drops to protect the corneas.

Clinical studies also show that acupuncture is at least as effective as corticosteroids and may improve the recovery of patients with palsy Bell, either as monotherapy or in combination with medication.