Facial palsy is the common name for facial neuritis, which is a common clinical disease and a common occurrence. Modern medicine mainly refers to facial nerve palsy caused by viral infection, also known as Bell’s palsy. It is different from the peripheral facial nerve palsy caused by trauma, tumor, external ear disorders and other physical factors, and the central facial nerve palsy caused by central nervous system lesions. The etiology of the disease is still unknown. According to clinical observation, there are factors such as external sensation, cold, mood swings, fatigue, and poor diet (alcohol consumption, spicy food). For the pathogenesis of facial palsy, it is currently accepted that viral infection and spasm of the blood vessels that nourish the facial nerve lead to nerve ischemia, which causes edema of the nerve sheath in the facial nerve canal, and edema further squeezes the blood vessels, especially the veins, which further aggravates the ischemia and further compresses the nerve, and eventually facial nerve paralysis occurs, which is what we call facial palsy. 1. Clinical manifestations Unilateral peripheral neurological facial palsy is mainly characterized by the disappearance of frontal lines on the affected side, enlargement of the eye fissure, inability to close the eyelids, overflow of tears, shallowing or disappearance of the nasolabial fold, and crooked corners of the mouth toward the healthy side. 2. Diagnosis and localization After the facial nerve emanates from the pontine brain, it passes through the internal auditory canal and the narrow bony canal in the rock bone, which is the facial nerve canal, and finally exits the cranial cavity through the stem mammary foramen to distribute to the facial expression muscles. According to the location of facial nerve injury, it can be localized as nuclear palsy, pontocerebellar angle palsy, intra-facial nerve canal, and extra-facial nerve canal. The first two are mostly seen in tumors and vascular lesions, and the latter two are clinically common. (1) Intra-facial nerve canal: the nerves in the facial nerve canal are ischemic, edematous, and obviously compressed, which easily lead to myelin or axonal degeneration, thus the condition is mostly heavy, with slow recovery, poor prognosis, and many sequelae. In addition to the clinical manifestations of facial palsy mentioned above, there may be hypogastric sensation in the anterior two-thirds of the tongue, i.e., damage to the bulbar nerve, and the patient may have numbness of the tongue and abnormal sensation of taste. (2) External facial nerve canal: edema and degenerative necrosis of facial nerve outside the stem mammary foramen are not obvious, the condition is mild and the prognosis is good. In addition to the above clinical manifestations of facial palsy, it is only accompanied by slight pain in the mastoid region. 3. Determination of the disease Electromyography examination has a definite guiding effect on the localization of facial nerve injury, but there is an obvious lag in the neurodegeneration response of electromyography examination, which often becomes obvious only 7-10 days after the onset of the disease. Generally speaking, the severity of the disease depends on the location of the facial nerve injury (intradural or extradural) and the degree of injury, and the higher the location and the more severe the injury, the worse the prognosis. According to the clinical manifestations of patients can be divided into three types: mild, moderate and severe. Mild: the movement of closing eyes, raising eyebrows, shrugging nose, puffing and showing teeth can be completed, but the force is weaker than that of the healthy side; moderate: some facial muscles are completely paralyzed, but some facial muscles can be seen to produce movement; severe: facial muscles are completely paralyzed or can see slight contraction of facial muscles, but no movement. 4. Clinical treatment Patients with facial palsy will have pain in the mastoid region on one side at the early stage, the painful pressure point is mostly behind our earlobe (cataract point), the pain sometimes radiates along the back of the ear to the head or along the front of the ear to the jaw, the painful symptoms are worse at night, the eyes on the affected side of the face will not close tightly, and water flows out uncontrollably from one corner of the mouth when gargling, with the above clinical symptoms, it can be initially judged to be suffering from facial neuritis, i.e. Facial palsy. (1) Western medicine therapy: In the acute and quiescent phase, Western medicine mostly uses oral hormone prednisone and drugs to improve microcirculation dibazol, intramuscular injection of vitamin B1, B12. Hormone therapy can change the cell membrane phospholipid composition, maintain the stability of the cell membrane, and achieve the role of anti-inflammatory and eliminate edema. Patients with hypertension and diabetes mellitus should not take oral hormone dibazol to improve local microcirculation and eliminate local edema as soon as possible. Intramuscular injection of vitamin B1 and B12 provides the material basis for nerve repair. Oral vitamin B1, B12 and dibazol can be taken during the recovery period. (2) Chinese medicine: Chinese medicine uses the treatment method of dispersing wind and clearing ligaments with activating blood circulation and resolving blood stasis, and clinical prescriptions are often used to activate blood circulation and clear blood stasis with whole tianma capsule and then with oral solution for clearing heat and detoxification. Acupuncture treatment in the early and resting stages: few needles, shallow stabbing is the main focus, and electroacupuncture and strong stimulation techniques are prohibited. More acupuncture points of Shaoyang meridian are taken and combined with acupuncture and bloodletting cupping. Recovery period: acupuncture plus acupuncture point injection (adenosine cobalamin for injection) 0.5J per day for each of the two points. (Acupoint injection should not be used too early) or acupuncture plus electroacupuncture can be used. Treatment of the post-acute period: fire needling plus acupuncture plus acupuncture point injection is appropriate. (Pay attention to the direction and depth of needling). (3) Physical therapy: ultrashort wave local irradiation is used for the acute phase (1-7 days) and the resting phase (7-15 days) Hyperbaric oxygen therapy Most peripheral nerve fibers have myelin sheaths, and nerve cell bodies and their nuclei play a key role in the growth, regeneration, and function and maintenance of cell protrusions. The regeneration and repair of injured nerves depends mainly on the integrity of the neurogenic cell body. Hyperbaric oxygen promotes the dispersion of oxygen to cells and tissues, thus hyperbaric oxygen can directly improve the hypoxic state of nerve tissue caused by the compression, spasm or disconnection of neurotrophic vessels, and delay, stop or reverse the secondary pathological changes and collapse of nerve fibers and cell bodies. In the early stage of the disease, most patients are very impatient and eager to cure the disease, hoping to be cured as soon as possible. However, the occurrence and development of the disease have their own developmental rules, and some methods that are too hasty will not be able to achieve a multiplier effect, but may aggravate the disease in the early stage. Such as early in the face using heavy stimulation needling techniques and electro-acupuncture therapy and patients prematurely massage and facial muscle training on their own. The above incorrect methods will lead to swelling or pain in the affected face, thus prolonging the recovery period of the disease: 1. Patients should rest more during treatment, should not watch TV, computer to avoid eye muscle fatigue, affecting the recovery of the eye nerve, but also should not talk too much, eat hard, cold food and affect the repair of the nerve around the mouth. 2. diet should be warm, soft, light and easy to digest, avoid spicy, fish, shrimp and beef and mutton and other irritating food to avoid aggravating the disease. 3 Avoid sexual intercourse to protect the body’s positive energy 4 You can do hot compresses on the face (15 minutes daily), but the temperature should not be too high and facial massage should not be done. The four complications of facial palsy are linkage: when the affected eye does the movement of closing the eyes, the affected side of the mouth angle does the synchronous upward movement; crocodile tears: when the patient chews food, the affected side of the eye has tears overflowing; inversion: when the onset of the affected side of the mouth angle is crooked to the healthy side, and inversion is the affected side of the mouth cross to the affected side; facial muscle spasm: the affected side of the facial muscle appears involuntary twitching; the above sequelae mostly appear after 3 months of the onset of the disease, if improper treatment of the above The above sequelae mostly appear 3 months after the onset of the disease, and if not treated properly, the above four may appear superimposed.