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Facial nerve palsy is a condition that can affect anyone regardless of age. The facial nerve is the seventh cranial nerve, and its paralysis is manifested by a partial disturbance in the mobility of the facial muscles. What are the causes of facial nerve palsy and how is the diagnosis of this ailment carried out?
Facial nerve – characteristics
The facial nerve is the seventh cranial nerve that is part of the peripheral nervous system. The facial nerve is a paired and mixed nerve that contains motor fibers, sensory fibers, and secretory fibers, otherwise known as sympathetic fibers. The facial nerve is responsible for the motor innervation of the facial muscles, as well as the muscles of the neck and inner ear muscles. It also innervates the skin of the auricle and the piece of skin behind the ears. The sensory innervation, which is the responsibility of the facial nerve, also includes the soft palate and hard palate, and the front part of the tongue. Parasympathetic fibers innervate the sublingual gland, the submandibular gland, as well as the glands of the lower mouth and the lacrimal glands. The most common discomfort affecting the functioning of the facial nerve is its paralysis.
Facial nerve palsy – causes
There are many reasons for the palsy of the facial nerve, but the most important ones include:
- congenital paralysis – caused by genetic defects or forceps delivery;
- infectious diseases, especially shingles, Lyme disease, otitis media;
- purulent parotitis;
- parotid gland cancer;
- injuries resulting in a fracture of the skull base, a fracture of the temporal bone or the area of the stylomastoid opening;
- tumor of the cerebellopontine angle;
- sarcoidosis;
- multiple sclerosis;
- Guillain-Barry Syndrome.
How to recognize facial nerve palsy?
Symptoms of facial nerve paralysis include all the components of the facial nerve fibers. The most common symptoms of facial nerve palsy include:
- drooping of the corner of the mouth on the side of nerve paralysis;
- Bell’s symptom, i.e. the symptom of the setting sun – when you try to close the eye, the eyeball points upwards and is only partially covered by an open eyelid;
- smoothing the nasolabial fold;
- ear ache;
- flabbiness of the cheek muscle;
- impairment of tearing and salivation;
- no sense of taste on the front of the tongue.
Diagnostics in the diagnosis of facial nerve palsy
The symptoms of facial nerve palsy are so characteristic that the doctor can diagnose the disease by carefully interviewing the patient. Determining the actual causes of the paralysis turns out to be much more difficult, so the specialist usually orders additional tests. The most frequently performed tests in the case of facial nerve palsy are computed tomography, electromyography and electroneurography.
Facial nerve palsy – treatment
Idiopathic facial paralysis is treated pharmacologically with glucocorticosteroids. If the paralysis was caused by a viral infection, antiviral medications are also used. In the treatment of facial nerve palsy, antibiotics are sometimes used, but this mainly applies to patients with Lyme disease or other bacterial diseases. To support the treatment, the doctor recommends the patient supplementation with B vitamins. Vitamin B6, vitamin B12 and vitamin B1 play a special role in the treatment. The next stage of treatment is rehabilitation, which uses ionopheresis, laser biostimulation and electrostimulation.
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