Facial neuralgia


Facial neuritis requires the use of steroids.
Bell's palsy, or facial neuritis, is caused by stimulation or viral infection of the facial nerves, leading to facial nerve paralysis. This generally refers to peripheral facial neuritis. Early treatment includes antiviral, anti-inflammatory, nerve nourishment, and free radical scavenging. Therefore, early treatment of facial neuritis requires steroid therapy, commonly using oral prednisone. The dosage is determined by body weight, at 1 milligram per kilogram, taken orally for a week, then discontinued. The next step in the treatment plan involves acupuncture and physical therapy. (Use of medications should be under the guidance of a doctor.)


How is facial neuritis best treated?
The treatment of facial neuritis primarily aims to improve local blood circulation, alleviate facial nerve edema, relieve nerve compression, and promote the recovery of nerve function. Therefore, its treatment includes medication, which mainly nourishes the nerves, and may also involve antiviral drugs and corticosteroids. Physiotherapy, particularly post-acute phase, can include acupuncture or infrared radiation and local heat application. Eye protection is also necessary because patients with facial neuritis may not be able to fully close their eyelids, leaving the cornea exposed and susceptible to infection. Finally, rehabilitation treatment includes acupuncture, which is also part of the mentioned physiotherapy.


Does facial neuritis need treatment?
Bell's palsy is a nonspecific inflammatory reaction, primarily caused by impairment of the facial nerve leading to paralysis of the facial muscles. In general, if the symptoms of Bell's palsy are mild, such as slight drooping of the corner of the mouth and drooling, there is a possibility for spontaneous recovery. However, if the symptoms of Bell's palsy are severe, and the patient also has risk factors for diabetes, these symptoms mainly include noticeably shallower forehead wrinkles, weakness in opening and closing the eyes, inability to close the eyes while sleeping, and very severe facial paralysis. In such cases, spontaneous recovery is difficult, and active treatment is required. Treatment mainly includes corticosteroid drugs and B vitamins, along with some rehabilitative training. In summary, Bell's palsy can resolve on its own if the symptoms are mild; however, if the symptoms are severe, timely treatment is necessary to avoid lasting effects.


Facial neuritis should visit which department?
Facial neuritis should be treated by the Department of Neurology, but after the acute phase, physiotherapy can be performed at the Rehabilitation Department. Facial neuritis is caused by non-specific inflammation of the facial nerve within the stylomastoid foramen, leading to peripheral facial paralysis. The exact cause is currently unclear, but it is believed to be related to optic nerve viral infections. It usually occurs after exposure to cold and upper respiratory infections, and can occur at any age, most commonly between 20 and 40 years, with a higher incidence in males than females. It starts acutely, peaking within a few hours or days, mainly presenting as paralysis of the facial expression muscles, disappearance of forehead lines, inability to frown or wrinkle the forehead, and inability to close the eyelids or incomplete closure. Therefore, during the acute phase, treatment in the Department of Neurology is necessary, and rehabilitation treatment can be sought after the acute phase in the Rehabilitation Department.


Is facial neuritis inflammation?
Bell's palsy is essentially an inflammatory reaction, but this inflammation is a nonspecific type. It also exhibits the typical inflammatory symptoms of redness, swelling, heat, and pain. However, this inflammation is not caused by direct infection from viruses, bacteria, or fungi. Since Bell's palsy is an inflammatory condition, its treatment must include corticosteroids for management. Additionally, administration of B vitamins is necessary to promote nerve function recovery. Moreover, targeted rehabilitation exercises, acupuncture, and local physiotherapy from the rehabilitation department also play a vital role in the recovery from Bell's palsy. Generally, with proper and timely treatment, Bell's palsy can fully recover, and most patients will not experience any impact on their future quality of life. However, if the symptoms of Bell's palsy are very severe, and the patient has a history of diabetes, the prognosis may be poorer.


Facial neuritis hormone treatment
If the diagnosis of facial neuritis is confirmed, and the patient does not have evident history of femoral head necrosis or diabetes, then it is advocated to treat facial neuritis with corticosteroids. Corticosteroids can suppress some of the inflammatory responses of facial neuritis, reduce edema, and facilitate the swift recovery of facial nerve function. The current guidelines recommend the use of corticosteroids for treatment. However, if the patient has conditions like elevated blood sugar, femoral head necrosis, osteoporosis, or gastric ulcers, the use of corticosteroids must be cautious to avoid adverse reactions. During the administration of corticosteroids, it is crucial to ensure the patient receives supplements of calcium and potassium to prevent electrolyte disturbances and osteoporosis. Besides corticosteroids, intake of B vitamins can also aid in promoting the repair of nerve functions.


Can facial neuritis heal by itself?
If it's a case of facial neuritis, generally very mild facial neuritis tends to heal on its own, but it takes time. Common symptoms of facial neuritis include incomplete eyelid closure and deviation of the mouth. More severe cases may even experience reduced taste and hearing. Under such circumstances, it is recommended that patients seek medical attention at a formal hospital as soon as possible to avoid delaying treatment. The best recovery period for facial neuritis is within three weeks; therefore, as time delays, the difficulty of recovery increases. Thus, we advise patients with particularly evident symptoms to seek medical care promptly.


What causes facial neuritis?
Facial neuritis, also known as idiopathic facial nerve paralysis or Bell's palsy, is caused by nonspecific inflammation of the facial nerve inside the cranial foramen, leading to peripheral facial paralysis. The exact cause is currently unknown, but it is thought to possibly be related to viral infections of the optic nerve, as well as potentially due to exposure to cold or upper respiratory tract infections. The mechanism of onset involves the bony facial nerve canal, which can only accommodate the facial nerve. However, if the facial nerve becomes ischemic and swollen, it will inevitably lead to nerve compression. Viral infections can lead to local autoimmune responses in the nerves and spasms of the nutrient vessels, resulting in ischemic swelling and facial nerve paralysis.


Symptoms of Post-Facial Nerve Neuritis
Facial nerve inflammation is caused by a viral infection due to a decrease in the body's resistance, leading to inflammation characterized by damage to the facial nerve. Its symptoms mainly include the lightening of the forehead wrinkles on the same side, incomplete closure of the eye, and drooping facial muscles due to lack of nerve support, resulting in facial nerve drooping which can cause symptoms such as skewed mouth corners, spilling while drinking, and drooling. Sequela depends on the symptoms of the disease, the timeliness of treatment, and the timeliness of recovery, but the ratio of symptomatic to asymptomatic cases is typically 50% and 50%. Young people, those with milder symptoms, those treated promptly, those treated appropriately, and those who recover well are less likely to suffer sequelae, and vice versa.


Is facial neuritis the same as facial paralysis?
Facial neuritis can lead to facial paralysis, but facial paralysis can be divided into central facial paralysis and peripheral facial paralysis. Generally, facial paralysis caused by facial neuritis is peripheral facial paralysis. This means that there might be incomplete closure of the eyelids and deviation of the mouth corners. If central facial paralysis is considered, it generally does not lead to incomplete closure of the eyelids. Central facial paralysis is mainly caused by cerebrovascular diseases or other diseases of the brain or brainstem, whereas facial neuritis is due to damage to the facial nerve.