Facial neuritis, also known as Bell’s palsy or “facial paralysis”, the etiology of which is still unknown, refers to an acute, non-suppurative inflammation of the facial nerve in the internal part of the facial nerve canal above the mastoid foramen. In Chinese medicine, it is called “distortion of the eyes and mouth”. It is believed that the occurrence of this disease is caused by the interaction between the invasion of external evil and the functional state of the body. I. Etiology and pathogenesis Facial neuritis is more common in cerebral neurological disorders, which is related to the anatomical structure of the facial neural tube as a long and narrow bony tube, when the abnormal development of the rocky bone, the facial neural tube may be even narrower, which may be an intrinsic factor in the development of facial neuritis. The extrinsic cause of the development of facial neuritis is not yet understood. According to the early pathological changes of facial nerve edema, myelin sheath and axial space with different degrees of degeneration, some people speculate that it may be due to the cold wind blowing on the face, the nutrient microvascular spasm of the facial nerve, resulting in ischemia and hypoxia of the local tissues. It is also thought to be related to viral infection, but no virus has been isolated. In recent years it has also been suggested that it may be an immune response. Geniculate ganglion syndrome is caused by herpes zoster virus infection, which results in inflammation of the geniculate ganglion and facial nerve. Clinical manifestations can be seen at any age, no gender differences. It is mostly unilateral and rarely bilateral. The onset of the disease has nothing to do with the season, usually acute onset, one side of the facial expression muscles suddenly paralyzed, can be peaked in a few hours. Some patients have pain in the postauricular mastoid area of the external auditory canal 1-3 days prior to the onset of the disease, often found in the morning when washing or found by others to be tilted at the corners of the mouth. Examination shows the disappearance of forehead lines on the same side, inability to frown, due to paralysis of the orbicularis oculi muscle, the eye fissure is enlarged, and when the eyes are closed, the eyelids cannot be closed or are incompletely closed while the eyeballs rotate outwardly and expose the white sclera, which is known as Bell’s phenomenon. The lower eyelid is ectropion, and the tears do not easily flow into the nasolacrimal duct and overflow out of the eye. The nasolabial folds become shallow on the sick side, the corners of the mouth droop, and the corners of the mouth are pulled toward the healthy side when showing teeth. When showing teeth, the corner of the mouth is pulled towards the healthy side. The patient cannot make pouting and whistling movements, the corner of the mouth on the sick side leaks air when puffing the cheeks, and the soup leaks out from the corner of the mouth on the sick side when eating and rinsing the mouth. Due to the paralysis of the buccal muscles, food often stays between the teeth and cheeks. If the lesion affects the tympanic nerve, in addition to the above symptoms, there may be loss of taste in the anterior 2/3 of the tongue on the same side. Involvement of the upper part of the peduncle muscle branch, due to the paralysis of the peduncle muscle, there may also be ipsilateral auditory hypersensitivity. When the geniculate ganglion is involved, in addition to facial paralysis, dysgeusia and auditory hypersensitivity, there are also ipsilateral salivary and lacrimal gland secretion disorders, intra-auricular and postauricular pain, and herpes zoster in the external auditory canal and auricle, which is called geniculate ganglion syndrome. Diagnostic points 1, acute onset: a few hours or 1-2 days to reach the peak. 2.Paralysis of the upper and lower parts of the muscles on the sick side: loss of expression muscles, disappearance of frontal lines, enlargement of the eye fissures, shallow nasolabial folds, and drooping of the corners of the mouth to the healthy side. The sick side cannot furrow the forehead, frown, close the eyes, show the teeth, whistle, puff out the cheeks and other movements. Direct and indirect corneal reflexes are lost on the sick side. (1) The lesion extends to the tympanic nerve above the mastoid foramen, resulting in loss of taste in the anterior 2/3 of the tongue. (2) Involvement of the stirrup nerve, in addition to loss of taste, there is also auditory hypersensitivity. (3) Involvement of the geniculate ganglion, on the basis of facial paralysis, loss of taste and auditory hypersensitivity, pain behind the ear, auricular or tympanic membrane herpes, known as Hunt’s syndrome. Functional exercise The voluntary or passive exercise of facial muscles can promote the recovery of facial muscle function. After electromyography determines that there is a neurodegenerative reaction or muscle denervation, exercise therapy and self-massage should be started at an early stage, and the method can be taught to the patient, so that the patient can exercise on his/her own in front of the mirror. Once a day, 20-30 minutes each time. The principle of facial muscle training: when the muscle strength is below grade 2, fingers can be used to help do passive movement, and when the muscle strength is above grade 3, do active movement, and at the same time, carry out the training of speed, sensitivity and coordination. Training methods 1, frontalis muscle: raise the eyebrows, do surprise-like movements, wrinkled forehead; middle finger and eyebrow parallel to the eyebrow on the eyebrow, let the patient raise the eyebrow at the same time to raise the eyebrow on the affected side, the fingers of the other hand on the healthy side of the eyebrow, limiting the healthy side of the muscle movement. 2, frown muscle: frown, two eyebrows to the center of the concentration, the middle finger on the affected side of the inner end of the eyebrow to the middle of the push, the fingers of the other hand to limit the healthy side of the movement. 3, orbicularis oculi muscle: forcefully close the eyes, press the middle finger on the eyebrow (on the arch of the eyebrow), gently push downward, eyelid closure, be careful not to make the middle finger pressure on the eyeball, use the other hand to inhibit the healthy side of the eye closure movement. 4, the root of the nose muscle: nasal muscle (wing, transverse), nasal septum descending muscle; the former can be made to wrinkle the root of the nose to complete; the latter can be made to open the nostrils, extend the lower part of the nose to complete. 5, lift the upper lip muscle: let the patient lift the upper lip, and forward protruding, the therapist will put the finger on the upper lip, the lip to the nostrils to lift; will be placed in the middle finger of the index finger on the edge of the upper lip gently lifted up, the healthy side of the upper lip to use the finger against, to limit its activities. 6, lifting the corners of the mouth muscles: let the patient show the teeth, leading the corners of the mouth upward and backward; the therapist’s fingers can pull the corners of the mouth upward to help the paralyzed side of the corners of the mouth upward. 7, smile muscle, zygomaticus muscle: let the patient like laughing to lead the corner of the mouth outward and upward, the index finger can be slightly into the affected side of the mouth or placed on the corner of the mouth, outward pulling; attention to limiting the healthy side of the movement, the healthy side of the corner of the mouth can be given some resistance to complete. 8, buccal muscle: shut up and draw the corner of the mouth backward, the fingertip can be placed on the corner of the mouth to pull the corner of the mouth backward, pay attention to limit the healthy side of the corner of the mouth movement. 9, orbicularis oculi, chin muscle: let the patient will be upper and lower lip pouting, with the finger from the upper or lower lip of the lower outer direction to the center of the push lips, in the healthy side of the upper and lower lip to exert pressure, to limit the healthy side of the movement. V. Precautions 1, hormone therapy must be carried out in the acute phase, generally 7 days after the gradual reduction of the amount, until the drug, in order to prevent the “rebound phenomenon. 2, the acute phase generally do not use strong stimulation therapy. 3.Facial muscle exercise should be carried out as early as possible.