The difference between facial neuritis and facial nerve paralysis

Written by Liu Shi Xiang

Neurology

Updated on March 11, 2025

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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.

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Written by Zhang Hui

Neurology

51sec

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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.

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Written by Tang Li Li

Neurology

1min 27sec

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How to Treat Facial Neuritis

Bell's palsy, once diagnosed, needs to be treated as early as possible, with better outcomes the earlier treatment is started. If the patient does not have any significant contraindications, corticosteroids should be used in the early stages. Common treatments include oral prednisone, typically for about ten days, or dexamethasone intravenous infusion, typically for about five to seven days. Alongside anti-inflammatory corticosteroids, nerve nourishment can be addressed with muscle injections of vitamin B1 and vitamin B12, and patients with better economic conditions can also use mouse nerve growth factor for muscle injection nerve nourishment. Additionally, if the patient has significant pain behind the ear, indicating a possible viral infection, concurrent treatment with acyclovir antiviral therapy should be administered. Later, if recovery is poor, rehabilitative treatment can be provided, including electro-acupuncture physical therapy, infrared magnetic heating, etc., all of which can promote the recovery of Bell's palsy. The overall treatment course approximately takes about 20 days, with total recovery time ranging from 20 days to two months. (Note: Medication should be used under the guidance of a physician, based on the actual conditions.)

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Written by Tang Bo

Neurology

42sec

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What should be paid attention to in daily life with facial neuritis?

If facial neuritis occurs, one should pay attention to eye care. Due to facial neuritis, eyelid closure may be incomplete, potentially allowing foreign objects or infections to enter the eye. Therefore, it is advisable to reduce outdoor activities, keep the eyes clean, and during social interactions, cover the affected eye with an eye patch or apply ophthalmic ointment to prevent conjunctival or corneal infections, while minimizing eye use. Regarding diet, some patients may experience disturbances in taste, so it is important to be mindful of the temperature of food, avoid hard food, and maintain oral hygiene.

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Written by Tang Bo

Neurology

48sec

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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.

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Written by Zhang Hui

Neurology

57sec

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Is facial neuritis prone to recurrence?

For idiopathic facial neuritis, this is a nonspecific inflammatory reaction caused by an immune function disorder of the body. The probability of recurrence of this disease is not particularly high. Patients should pay attention to exercising and enhancing their physical fitness. During the onset of the disease, treatment with corticosteroids, B vitamins, etc., should be given, and the prognosis is generally good with a very low recurrence rate. However, it should be noted that sometimes facial paralysis may be caused by other diseases, such as some tumors, especially malignant lymphomas, whose initial symptoms might affect the facial nerve, causing repeated paralysis. Clinically, when seeing patients with repetitive facial neuritis, it is crucial to consider the possibility of such diseases to avoid missed diagnoses. (Medication should be used under the guidance of a doctor.)