1.What is facial palsy?
Facial palsy means facial muscle paralysis, which is caused by damage to the facial nerve that governs the facial muscles, so it is clinically called facial nerve paralysis, and in Chinese medicine, it is called “mouth seclusion” or “mouth-eye distortion”. It is an unfamiliar word to the general public, but in fact, it is all around us. Usually, we see people with crooked mouths, poorly closed eyes, difficulty in rinsing their mouths after eating, or feeling numbness in the face, especially when laughing, the two sides of the face look extremely asymmetrical.
The clinical manifestation of facial palsy is very special: most patients often suddenly find that one cheek does not move well and the mouth is crooked when they wash their face or rinse their mouth in the early morning. If the facial expression muscles are completely paralyzed, the forehead wrinkles disappear, the nasolabial folds are flattened, the corners of the mouth droop, and the corners of the mouth are skewed to the healthy side when the teeth are exposed. The patient’s side cannot make movements such as forehead wrinkling, frowning, eye closing, puffing and pouting. When puffing the cheeks and whistling, the affected side of the mouth leaks air because the lips cannot be closed. When eating, food residue is often retained in the teeth and buccal space of the affected side, and saliva often flows down from that side. Tears often fail to drain as normal and spill out.
2.Why does facial palsy have various manifestations?
There are many large and small muscles around the face, such as the eyes, mouth, and nose, and these muscles are arranged horizontally and vertically. It is also these muscles that contract and relax in a coordinated manner to allow people to close their eyes, open their eyes, open their mouths, and close their mouths freely, and to move the skin of the face to show various expressions of joy, anger, sadness, and happiness. However, the coordinated movement of facial muscles is governed by the facial nerve. Once the facial nerve is damaged, such as by infection, tumor compression, trauma, etc., the facial muscles lose command and are in a state of paralysis, resulting in the inability to close the eyes and the mouth is not closed properly. Sometimes there is also abnormal facial sensation, numbness and discomfort, as well as dullness of taste in the first 2/3 of the tongue. Facial palsy facial muscle spasm mainly manifests as crooked mouth and eyes, numbness and twitching of facial muscles, salivation at the corners of the mouth, eyebrows cannot be raised, meal storage and facial expressionlessness.
3.How many types of facial palsy are there and what are their characteristics?
According to the location of nerve damage, facial palsy should be divided into peripheral facial palsy (peripheral facial nerve palsy) and central facial palsy (central facial nerve palsy), and the specific clinical manifestations of the two are also different.
4.What are the general symptoms of peripheral facial palsy?
When peripheral facial nerve palsy occurs, it causes paralysis of all facial muscles on the affected side. In other words, the upper and lower facial muscles are paralyzed, the eyelids cannot be fully closed, and the eyeballs move up while the eyes are closed. When the patient shuts up, the corners of the mouth droop, the eyebrow lift is limited, the forehead wrinkles become shallow or disappear, the eyebrows are lower than on the healthy side, and tears sometimes spill outward. The corners of the mouth are pulled toward the healthy side when the teeth are shown or when laughing, and the mouth is obliquely oval. When speaking, the articulation of lip sounds is unclear. Due to the paralysis of the buccal muscle, food is stored between the buccal muscle and the gums, so that the patient must use chopsticks to pull out the food. When facial nerve palsy occurs in infants, sucking is limited. When bilateral peripheral facial nerve palsy occurs, the face is expressionless, bilateral frontal lines disappear, eyes cannot be closed tightly, bilateral nasolabial folds become shallow, lips cannot be closed tightly, the corners of the mouth leak, food is retained in the cheeks when eating, and speech is slightly ambiguous.
5.What is Bell’s palsy?
Bell’s palsy, also known as facial neuritis, is a simple peripheral facial nerve palsy that is not clinically certain what is causing it and has no other symptoms.
6.Why does Bell’s palsy occur?
It is generally believed that due to the stimulation of wind and cold, the local blood vessels that nourish the nerve become constricted, resulting in ischemia and edema of the nerve tissue, causing the nerve to be compressed; or infectious inflammation and swelling occurs, compressing the nerve, resulting in impaired blood circulation and affecting nerve function, and facial nerve paralysis occurs.
7.What are the clinical manifestations of Bell’s palsy?
The main manifestation is paralysis of all the expression muscles on one side of the face. The forehead wrinkles disappear, eyes are closed, forehead frowning and frowning are not possible, eye closure is incomplete, the nasolabial folds on the affected side become shallow, the corners of the mouth droop, and the mouth is crooked to the healthy side. There may be spontaneous pain and pressure behind the ears, and there may also be little sensation of taste in the tongue part, auditory hypersensitivity, pain or dullness of sensation in the external ear canal, and herpes.
8.What is the prognosis of Bell’s palsy?
As long as the correct and reasonable treatment is chosen immediately after the onset of the disease, most of them can improve and recover within 1-3 months, and if the disease lasts for more than 6 months, as long as comprehensive treatment and rehabilitation means are used, the disease can be recovered to different degrees, but it may leave sequelae.
9.Why does facial palsy leave sequelae?
A: Facial palsy can be recovered with timely and effective treatment, and the recovery rate is over 90%. In fact, the damaged facial nerve is not completely repaired. It is basically normal not to speak or make expressions, but there will be some obstacles when making movements such as puffing cheeks, nuzzling, raising eyebrows and laughing. However, it is difficult for a small number of patients to fully return to the normal facial state, which must be treated to maximize the improvement of facial expression disorder and adhere to simple facial massage to effectively prevent muscle atrophy.
10.What is facial muscle spasm?
Facial muscle spasm is also called facial muscle twitching, that is, one side of the face twitches (individuals appear bilateral spasms), the more nervous and excited the spasm is more serious. Because the early manifestation of facial muscle spasm is eyelid jumping, and the folk saying “left eye jumping for money, right eye jumping for disaster”, so generally do not attract people’s attention, after a period of development, it will become facial muscle spasm, linked to the corner of the mouth, and serious with the neck. Facial muscle spasm can be divided into two types, one is primary facial muscle spasm, and the other is facial muscle spasm produced by the sequelae of facial paralysis. In primary facial myospasm, it can occur even at rest, and the spasm is relieved after a few minutes and is uncontrolled; in facial myospasm produced by the sequelae of facial palsy, it is produced only when doing actions such as blinking and raising eyebrows. This disease is a slowly progressive disease and generally does not heal on its own.
11.Can newborns also get facial palsy?
Infants and children can also develop facial palsy due to infection, congenital or other factors.
As a parent, it is not difficult to find out if your child is normal if you observe him or her carefully. Observe whether your child’s face is symmetrical when he is asleep or quiet, whether his eyes are closed, his mouth is open, or whether he is crying or laughing (facial nerve examination), and whether he has a normal reaction to something sweet or bitter (taste examination). If none of these are abnormal, then it is safe to assume that your child is normal.