What causes facial neuritis?

Written by Tang Bo
Neurology
Updated on September 02, 2024
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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.

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Neurology
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Does facial neuritis cause vomiting?

Patients with facial neuritis generally do not experience vomiting. The main symptoms in patients are paralysis of the facial expression muscles around the eyes and mouth, which may present with the disappearance or lightening of the wrinkles on the affected side of the forehead, enlarged eye slits, incomplete eyelid closure, and exposure of the white sclera when attempting to close the eyes. Additionally, flattening of the nasolabial fold may occur, as well as reduced or lost taste sensation in the anterior two-thirds of the tongue. Patients may have symptoms such as a crooked mouth when whistling, air escape when puffing cheeks, and food retention on the affected side during meals, which increases the risk of oral infections and conjunctivitis. If vomiting occurs, other causes should be actively considered, such as the possibility of high blood pressure or electrolyte imbalance like hyponatremia. Dietary indiscretion could also be a cause, necessitating a comprehensive analysis.

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Written by Yuan Jun Li
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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.)

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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.

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Written by Yuan Jun Li
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Can facial neuritis eat fish?

Patients with facial neuritis who are not allergic to seafood can eat fish. Fish contains a large amount of high-quality protein, which can supplement the essential proteins needed by the human body and improve the patient's physique. Patients can also eat other lean meats and poultry eggs, and consume plenty of fresh vegetables and fruits. If a patient develops facial neuritis, they should avoid spicy and stimulating food, such as hot peppers. Active treatment should also be pursued, including the early use of corticosteroids such as dexamethasone and prednisone, as well as drugs that nourish the nerves, commonly including B vitamins, vitamin B12, vitamin B1, and derivatives of B vitamins such as adenosylcobalamin and methylcobalamin. One week after the onset, acupuncture and physiotherapy can be considered, and many patients can be clinically cured. (Medication should be used under the guidance of a physician.)

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Written by Zhang Hui
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Symptoms of facial neuritis

Facial neuritis, known as idiopathic facial paralysis, is a common disease in neurology. The main clinical manifestations and symptoms include acute onset, peaking within several hours to days. The primary manifestation is paralysis of the expression muscles on the affected side of the face, such as diminished forehead wrinkles, inability to open the eye, furrow the brow, or weak eyelid closure. Some patients may experience pain behind the ear, and in the tympanic membrane and external ear canal. Additionally, some patients exhibit deviation of the mouth corner, air leakage when puffing or whistling, and difficulty retaining food residues while eating or leaking water while drinking. Other patients may experience loss of taste in the anterior two-thirds of the tongue, along with secretion disorders of the salivary and lacrimal glands. Overall, the diagnosis of facial neuritis is relatively straightforward, and its clinical presentation is not particularly complex. Once the diagnosis is confirmed, timely treatment is essential, and most patients can recover.