Symptoms of facial neuritis

Written by Zhang Hui
Neurology
Updated on September 29, 2024
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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.

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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.

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Does facial neuritis cause facial pain?

Facial neuritis is mainly caused by idiopathic facial nerve paralysis, which primarily manifests as paralysis of the facial muscles. Symptoms include deviation of the mouth, eyelid closure, lack of strength in opening the eyes, and shallowing of the nasolabial fold. Some patients' conditions are related to viral infections, which may cause facial pain. However, the pain is generally not very severe, and anti-viral medications can be used for treatment, which are somewhat effective. Additionally, active treatment of facial neuritis mainly involves the use of corticosteroids and is supported by the administration of B-group vitamins. Most patients, with timely and active treatment, have a relatively very good prognosis, with many experiencing no residual effects. (Please take medications under the guidance of a professional physician, do not self-medicate.)

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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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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.

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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.