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Abstract: A 32-year-old young male presented to our hospital with symptoms of widening of one eye fissure, incomplete eyelid closure, and crooked corners of the mouth after exposure to wind. The patient was treated with medication, auricular acupuncture and infrared therapy, and the patient’s symptoms were relieved and his condition gradually recovered.
Basic information】Male, 32 years old
Disease Type】Idiopathic facial nerve palsy
Hospital】Baoding First Hospital of Traditional Chinese Medicine
Date of consultation】April 2022
Treatment plan】Medication (Huafengdan, Zhachong XIII flavor pill, vitamin B12 injection) + physical therapy (ear acupuncture, infrared therapy, facial muscle exercise)
Treatment period】2 months of hospitalization
Treatment effect】The condition was controlled and the crooked corners of the mouth were basically restored to normal.
I. Initial consultation
The patient, a 32-year-old male, had symptoms such as enlarged right eye fissure, incomplete eyelid closure, left-sided crooked mouth, and right-sided salivation due to wind two days ago, along with pain behind the right ear. From the patient’s symptoms of orofacial distortion combined with the cranial MRI scan, we basically excluded acute cerebrovascular disease and intracranial occupying lesions, and clinically supported the possibility of neurological disease. The patient’s history of otitis media, vaginitis, and other complications of otogenic facial nerve palsy was not detailed, and the blood glucose was not elevated, so the diagnosis of idiopathic facial nerve palsy was confirmed, except for facial nerve damage caused by diabetes.
II. Treatment history
The patient was treated symptomatically, firstly, he was given Huafeng Dan and Zachong XIII Pill orally, and vitamin B12 injection to nourish the nerve and relieve the inflammation of the nerve, and auricular acupuncture therapy to stimulate the patient’s ear acupuncture points, and infrared therapy to further control the patient’s condition. The patient was advised to keep warm and avoid wind and cold, and to pay attention to facial muscle exercises such as frowning, eye closing and cheek puffing in front of the mirror several times a day for a few minutes each time, and to perform facial muscle massage.
III. Treatment effect
After 1 week of treatment, the patient’s symptoms gradually recovered and the pain behind the ear gradually disappeared. After 2 weeks of treatment, the patient’s right eye fissure became larger, the right eyelid closed incompletely and the crooked corners of the mouth were significantly improved, and the patient was discharged. After discharge, the patient continued to take oral medication and regularly underwent auricular acupuncture and infrared therapy in the outpatient clinic, and after 2 months, the patient’s symptoms such as crookedness of the corners of the mouth basically returned to normal.
IV. Notes
Although the prognosis for idiopathic facial nerve palsy in young people is good and clinical recovery is basically possible, there is a possibility of recurrence. Therefore, patients are advised to pay attention to avoid wind and cold, especially in the summer to avoid the cold and blowing air conditioning, electric fans, etc.. The patient is advised to avoid overexertion and to take part in physical exercise to prevent the resistance from decreasing.
V. Personal insight
If there is no history of “three highs” such as hypertension, hyperglycemia and hyperlipidemia, and the patient presents with symptoms such as crookedness of the corners of the mouth, and the cranial MRI excludes intracranial occupying lesions and acute cerebrovascular lesions, idiopathic facial nerve palsy is considered. In case of incomplete facial palsy, the recovery period is usually 1-3 weeks after the onset of the disease, and significant recovery or healing is expected within 1 month. Since patients and family members may be anxious when facial palsy symptoms appear, fearing that it is an acute cerebrovascular disease such as “cerebral infarction” or “cerebral hemorrhage”, it is necessary to do a good job of knowledge dissemination and inform them that it will not affect their lives, so as to relieve their anxiety and help This will help to speed up the recovery of the disease.