What is facial palsy?
Facial palsy, or peripheral facial nerve palsy. It is caused by damage to the facial nerve, which governs the motor function of the facial expression muscles, resulting in impaired movement of the facial muscles. In Chinese medicine, it is called “mouth distortion” or “mouth-eye distortion”. It is generally believed to be caused by acute non-suppurative inflammation of the facial nerve that passes through the facial nerve canal. The main pathological changes are edema of the facial nerve and varying degrees of degeneration of the myelin sheath or axons.
Etiology
The exact etiology is unknown.
Facial palsy may be caused by a viral infection (e.g., herpes simplex virus, varicella zoster virus, etc.). Facial palsy often occurs after the local cold wind or cold, so it may be caused by the cold causing spasm of the blood vessels that nourish the facial nerve, resulting in ischemia of the nerve and capillary damage, and edema; edema further aggravates the pressure on the nerve and obstructs the flow of lymph and blood, forming a vicious circle and leading to facial palsy.
According to Chinese medicine, this disease is caused by the lack of positive energy in the human body and the attack of wind and cold (rain, wind, air conditioning, cold, etc.) on the face and ears, which leads to the deficiency of wind and cold evil and paralysis of qi and blood, resulting in local stagnation of meridians and tendons and muscles.
The incidence is higher in pregnant women than in the general population, especially from 2 weeks before to 2 weeks after childbirth. The incidence of diabetes mellitus is 4-5 times higher than that of the general population. 7-10% of patients have a family history.
The disease may develop at all ages, with a prevalence between 30 and 45 years of age, and is relatively uncommon before the age of 15.
About half of the patients have a history of head and face cold before the disease, about 20% have excessive fatigue before the disease, and about 20% have a history of upper respiratory tract infection before the disease.
Clinical manifestations
Many patients report no abnormalities before going to sleep, but when they wake up in the morning, they feel that they cannot drink and rinse, or they do not feel anything but others notice it first. This sudden onset of unilateral facial palsy without other symptoms or signs is often a typical manifestation of facial palsy.
Most facial palsy recovers within 1-6 months, with 70%-85% recovering completely or recovering relatively well, while a small number of patients may not recover at all or may have a suboptimal recovery. Unsatisfactory recovery is common in patients with herpes in the ear, patients with a previous history of facial palsy, patients with severe facial palsy at the time of onset, patients who have not been treated in a timely manner, elderly patients, patients with diabetes, patients with hypertension, or patients with significant pain behind the ear. Recurrence is possible in about 10% of patients.
Complications or sequelae that may arise in patients with suboptimal recovery include facial muscle paralysis, spasticity, joint band movements, contractures, crocodile tear sign, dry eyes, altered hearing and altered sense of taste.
Facial muscle paralysis, i.e., reduced frontal lines, difficulty in closing the eyes, crooked corners of the mouth, and facial asymmetry that is more pronounced when blinking and laughing. Facial muscle spasm, i.e. the patient’s facial muscles twitch involuntarily. Associative movements, i.e. the patient’s mouth twitches when the eyes are closed, or the eyes close together when the mouth moves. Facial muscle contracture, which manifests as deepening of the nasolabial folds on the affected side, narrowing of the facial cleft, and reverse traction of the corners of the mouth on the affected side, resulting in pseudo-paralysis of the healthy facial muscles. Crocodile tear sign, which is manifested as involuntary tearing of the affected eye when the patient eats food, especially when eating food with strong flavor, or even when just seeing or thinking of delicious food.
Common sense prevention
Facial neuritis is a relatively common “orofacial distortion disease” among young and middle-aged people. If you experience pain around the ear on one side, along with the inability to close the eyes and face on that side, and the corners of the mouth are skewed to the opposite side, you should go to a neurological hospital immediately. Patients with facial neuritis who receive hormone therapy within 3 days of the onset of the disease, especially within 24 hours, will achieve a satisfactory recovery in about 90% of cases. Patients should tell their doctors about other diseases they have (e.g., diabetes, gastroduodenal ulcer, tuberculosis, hypertension, etc.) so that they can reasonably develop a treatment plan.
How to treat facial palsy
Once facial palsy in the acute stage is diagnosed, hormones, methylcobalamin and symptomatic treatment should be used as early as possible if there are no contraindications to medication. If the best time for treatment is delayed, it will easily cause various complications and sequelae of facial palsy. Acupuncture has a long history and reliable efficacy in treating facial palsy.
What should I do if I have facial palsy?
From the appearance of symptoms to the cure of facial palsy, there are usually four stages of disease development. The first week is the period of facial nerve paralysis; the second to three weeks is the period of stabilization; the third to four weeks is the period of facial nerve recovery; and the first month to the sixth month is the period of facial nerve recovery. Even if the condition is discovered and immediately goes to the hospital for regular treatment, it will go through these four stages of development. Especially in the first week to the second week, the symptoms will show aggravation. This is not because the treatment is not effective, but is a normal manifestation of disease progression. If no treatment is given, the symptoms may become more severe.
Some people give up formal treatment and use drugs indiscriminately on their own because they see that the disease does not get better, but gets worse. This is very wrong. The treatment of facial palsy needs a process and should never be rushed. This is because the survey shows that psychological factors are one of the important factors that trigger facial nerve palsy. Before the occurrence of facial nerve palsy, a significant number of patients have physical fatigue, lack of sleep, mental tension and physical discomfort. Therefore, the treatment process should also pay attention to maintaining a good mood and ensuring sufficient sleep. In fact, if the condition is detected in time and seen in a regular hospital, 70% to 85% of patients with facial palsy are able to recover ideally.
Some people who are treated in a timely manner have better symptom control, but stop treatment when they have not fully recovered. This is also very wrong, because whether facial palsy can be cured depends firstly on whether the treatment is timely and secondly on whether the treatment is thorough.
How to reduce the occurrence of facial palsy?
1.Enhance physical fitness, diet and living can reduce the occurrence of facial palsy. The disease should be prevented before it happens. The occurrence of facial palsy is often due to physical weakness after exertion, tension or sweating, decreased body resistance, and wind and cold on the head and face. Therefore, pay more attention to the following points in life, you can definitely prevent the disease from happening in the first place.
2, away from the wind and cold blowing cold wind, stimulated by cold water is the most common causative factors, so do not want to blow for a while, straight long blowing air conditioners, fans, especially in physical activity after a big sweat. In the car, outdoor cool, bathing, after drinking alcohol should also be careful not to let the wind blow directly on the head and face, especially the elderly and frail, after illness and suffering from hypertension, arthritis and other chronic diseases, especially should pay more attention. Do not wash your face with cold water, and perform foot massage after soaking your feet in hot water for 10-20 minutes every night before going to bed.
3, pay attention to rest During the prevention and treatment of facial palsy, you should pay attention to rest, ensure sufficient sleep, watch less TV, computer, avoid various mental stimulation and over fatigue, in order to facilitate the recovery of the disease.
In the face of pressure from work, study, social life and family life, you should learn to adjust yourself psychologically, such as confiding in others, listening to music, traveling, and exercising appropriately.
5, appropriate exercise in the morning and evening cooler according to their own situation to choose some suitable sports, such as: walking, gymnastics, playing tai chi, dancing, etc., long-term persistence, will make the body cycle to improve the susceptibility to wind and cold and resistance will also be greatly enhanced.
6, reasonable diet less greasy stagnant stomach, not easy to digest food. To eat more vegetables and fruits, such as peaches, grapes, bitter melon, eggplant, green pepper, leek, to maintain adequate vitamin intake. In addition, you should eat some rice, noodles and coarse grains to maintain sufficient energy supply and enhance the ability to resist diseases.
Seek timely medical treatment Once the disease develops, go to a regular hospital in time to avoid missing the best treatment.