Facial neuralgia


Clinical manifestations of facial neuritis
**Point One**: Patients with facial neuritis may exhibit clinical manifestations such as crooked mouth corners and shallower nasolabial folds. They may also experience water leakage while drinking, disappearance of forehead wrinkles, weakness in closing the eyes, and some patients may even sleep with their eyes open. **Point Two**: Patients might also experience taste disturbances, particularly noticeable in the anterior two-thirds of the tongue, and may also have secretion disorders of the salivary and lacrimal glands. **Point Three**: Some patients may experience hypersensitivity to sound, characterized by herpes on the tympanic membrane of the external auditory canal. Facial neuritis is a nonspecific inflammatory response, and treatment with corticosteroids can be effective.


How is facial neuritis treated?
Facial neuritis is generally prone to occur in patients with immune dysfunction, with factors such as viral infections and some patients may be related to cold stimulation from air conditioning or fans on the face. The treatment of facial neuritis mainly includes the following aspects: First, glucocorticoid treatment should be given. Glucocorticoids play a very important role in the treatment of facial neuritis. They can reduce abnormal inflammatory responses and swelling of the facial nerve, which greatly helps the patient's recovery. Second, some B vitamins should be given to nourish the nerves. If the condition is caused by viral infection, antiviral medication should also be provided. In addition, some rehabilitation training is particularly important, and it is recommended that patients receive early physiotherapy and functional training for facial muscles.


Does facial neuritis cause fever?
Bell's palsy can cause fever, usually a low-grade fever. When the body temperature is between 37°C and 38°C, it is generally referred to as low-grade fever. The primary cause of Bell's palsy is viral infection. Patients may also exhibit symptoms such as eye fissures, paralysis of the facial expression muscles of the upper and lower face, disappearance of forehead creases, enlargement of the eye fissures, incomplete eyelid closure, showing white sclera when the eyes are closed, shallowing of the nasolabial folds, deviation of the mouth corners, air leakage when whistling, air escaping when puffing cheeks, loss or reduction of taste in the anterior two-thirds of the tongue, and difficulty in retaining food on the affected side when eating. Patients are prone to developing oral inflammation and conjunctivitis. Early and proper treatment after the onset is crucial, and most patients can achieve clinical cure after treatment.


What causes facial neuritis?
Facial neuritis is very common in neurology, mainly caused by nonspecific inflammatory responses. For example, some patients with facial neuritis may experience viral infections, leading to inflammatory reactions in the muscles. Some patients develop inflammation of the facial nerve due to exposure to cold winds. Others may have immune dysfunction or rheumatic autoimmune diseases, which lead to inflammation of the facial nerve. Patients with facial neuritis usually experience paralysis of the facial muscles and may also experience significant pain, especially in the mastoid and external auditory canal. It is essential to treat facial neuritis early, using corticosteroids and B vitamins, as many patients have a good prognosis after treatment.


The difference between facial neuritis and facial nerve paralysis
The difference between facial neuritis and facial nerve paralysis is that facial neuritis refers specifically to peripheral facial paralysis, while facial nerve paralysis is a broader concept. It includes peripheral facial palsy caused by facial neuritis, as well as central facial palsy caused by cerebrovascular diseases. Therefore, the two have different clinical concepts and symptoms. Facial neuritis can involve paralysis of the entire facial muscles, including the disappearance of forehead lines and the shallowing of the nasolabial fold below the eye slit, as well as deviation of the mouth corner. Facial nerve paralysis, in addition to the symptoms caused by facial neuritis, may also include central facial palsy caused by cerebrovascular diseases. Central facial palsy does not affect the facial muscles above the eye slit, but only causes paralysis of the facial muscles below the eye slit, including shallowing of the nasolabial fold and deviation of the mouth corner. Therefore, facial nerve paralysis is a more extensive concept.


What should not be eaten with facial neuritis?
Bell's palsy primarily refers to the idiopathic paralysis of the facial nerve. This condition is quite common and can occur in individuals of any age. Essentially, it is a non-specific immune inflammatory response. Patients should be cautious about their diet, avoiding spicy and stimulating foods, as these can exacerbate facial nerve swelling, which is detrimental to recovery. Additionally, alcohol consumption should be avoided as it can significantly damage the nerves. There are no special dietary restrictions otherwise; it is recommended to consume more fresh vegetables and fruits, such as greens, apples, and oranges. Consuming foods rich in B vitamins, like buckwheat, sorghum, and corn, is also advised.


Causes of facial neuritis
The etiology of facial neuritis is not very clear, but some views suggest that viral infections can cause edema of the facial nerve, leading to compression of the nerve and resulting in inflammation. Additionally, some nonspecific inflammatory responses can also lead to edema of the facial nerve, presenting some clinical manifestations of facial paralysis. Other high-risk factors for facial neuritis include diabetes, autonomic instability, rheumatoid immune diseases, lymphoma, etc. Therefore, it is evident that the mechanisms of facial neuritis onset are unclear, with potential causes including viral infections, diabetes, central nervous system lymphoma, or autonomic instability, all of which can lead to facial neuritis. The primary symptom of facial neuritis is paralysis of the facial muscles. With standard treatment, complete recovery generally occurs within one to two months. Facial neuritis caused by tumors tends to recur and requires heightened vigilance.


Nursing measures for facial neuritis
The treatment of facial neuritis, in addition to some pharmacological treatments including corticosteroids, B vitamins, and antiviral medications, also requires some rehabilitative physiotherapy training. On the other hand, nursing measures also play an important role in the recovery from facial neuritis. The nursing measures for facial neuritis mainly include: First, it is essential to soothe the patient's emotions. Patients with facial neuritis often become quite depressed and may experience anxiety and depression. Nursing work must be thorough, including explanation and reassurance. Only when the patient's emotions are stable, can they cooperate with the treatment. The second nursing measure is to advise patients not to consume spicy and irritating foods. Third, it is important to keep the face warm, and patients can wear masks. Fourth, it is crucial to take good care of the eyes, as patients with facial neuritis often have difficulty closing their eyes, which can easily lead to eye infections. Eye drops can be administered to the patient.


What should I do if facial neuritis is accompanied by a fever?
Patients with facial neuritis who experience a fever with a body temperature above 38.5°C can undergo antipyretic treatment. They can take oral acetaminophen or ibuprofen, or receive intramuscular injections of Chaihu and Lysine Aspirin Injection. Simultaneously, antiviral medications should be used, such as ribavirin, oseltamivir, ganciclovir, and acyclovir, etc. It is also crucial to actively use medications that nourish the nerves, such as oral vitamin B1, vitamin B12, cobamamide, and methylcobalamin. During the acute phase, corticosteroids, which also have a certain antipyretic effect, can be used to reduce local edema and promote the absorption of inflammation. Dexamethasone and prednisone are commonly used clinically, and the medication period should generally not exceed two weeks, etc. (Medication should be used under the guidance of a physician.)


How long does facial neuritis require acupuncture treatment?
Facial nerve neuritis, acupuncture is a very important rehabilitation method for it. The duration of acupuncture should be analyzed based on different individuals. Acupuncture mainly helps with the recovery from facial nerve neuritis. The duration of acupuncture is primarily to restore the movement and sensation of the facial expression muscles on the affected side to be almost the same as the healthy side. At that point, acupuncture can be stopped. Based on clinical situations, most people might need about 2-3 courses of acupuncture to see improvement. However, there are a very small number of people who might need a longer duration of acupuncture, such as 4-5 courses, and some even longer. The duration of acupuncture depends on the location of the nerve damage. If the damage is close to the inside of the skull, the duration might be longer, whereas if it's closer to the outside, it might be shorter. Additionally, the constitution of the patient also plays a role; patients with a stronger constitution might require less time, while those who are weaker, older, or have complications such as diabetes might need a longer duration of acupuncture.