Facial nerve paralysis: how can winter and stress trigger a dangerous illness?

If you are concerned about facial asymmetry:

• Don't rush to see a surgeon!

  Any surgical intervention is a risk. Especially if the operation does not eliminate the cause of the problem.

• Don't rely only on cosmetics!

  You can paint and repaint a damaged car as much as you like. But that won’t stop her from being beaten. It's the same with the face...

Treatment at the Orto-Artel clinic without surgery!

We will help you understand the correction of facial asymmetry. And we will decide “wisely”, based on the reason.

Problems of facial aesthetics are of more and more concern to our patients. “How to correct facial asymmetry?”, “How to correct an asymmetrical face?” or “If the face is not symmetrical, what should I do?” We hear such questions very often. But how is this usually solved in other clinics? Cosmetologists, plastic surgeons. And all of them are in demand and promise good results. But is turning to a surgeon always justified? And can a cosmetologist always help? And most importantly, is there an alternative to surgery and all these “Botox”, “golden threads” and other “medicines” for the face? Indeed, very often, in pursuit of aesthetics, wanting to get results here and now, patients forget about the main thing - health.

Treatment in installments

The Orto-Artel clinic offers installments for the entire process of treating any disease. Personal conditions are considered on an individual basis.

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One of the most common problems is various types of facial deformities. The range of such asymmetries, as well as complaints and tasks that patients set for themselves in order to achieve a harmonious face, is very diverse. Some people don't like the fact that the right and left halves of the face are not the same. Someone is concerned about different eye sizes (see “Deformation of the cranial bones”). Someone has an asymmetrical jaw: the lower jaw moves to the side when opening the mouth, or the center of the upper jaw (the line between the central upper incisors) is shifted to one side (see “Crossbite”). And some people have ears at different levels and protruded differently. Someone’s jaw protrudes (see “Mesial bite”) or, conversely, “sinks” (see “Distal occlusion”). And someone has an asymmetrical chin.

In general, our patients have a great many complaints and complaints. But, despite this variety of expression and manifestations of facial asymmetries, these problems are corrected, as a rule, for some reason very superficially: either cosmetologists “inject”, “pump” or “rub” something, or surgeons do plastic surgery, something cutting or enlarging.

But it should, however, be understood that an asymmetrical face is not a diagnosis. This is just a symptom of a problem. A symptom, in medical terms. But treating symptoms is a thankless task. It is much more important to find the cause of the problem and eliminate it.

Diagnostics is the first and key step in the treatment of facial asymmetry. Do you want to know why it’s impossible to do without diagnostics?

general information

The trigeminal nerve consists of sensory and motor fibers. It originates in the structures of the brain and is divided into three branches:

• ophthalmic: responsible for the eye, forehead and upper eyelid;
• maxillary: innervates the area from the lower eyelid to the upper lip;
• mandibular: involves the chin, lower jaw, lips and gums.

With neuralgia, one or more branches of the trigeminal nerve are affected, which determines the main symptoms of the pathology. People over 45 years of age are most susceptible to the disease, and women get sick more often than men.

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Causes

The causes of trigeminal neuralgia can be of different nature:

• compression of the entire trigeminal nerve or its branches against the background of: enlargement of the arteries or veins of the brain (aneurysms, atherosclerosis, strokes, increased intracranial pressure due to osteochondrosis, congenital developmental features);
• tumors of the brain or facial tissues in close proximity to nerve fibers;
• congenital anomalies of bone structure, narrowed openings through which nerve branches pass;
• injuries of the skull, facial area: bone fractures, post-traumatic scars of soft tissues;
• proliferation of scar tissue after injury, surgery, inflammation;

The risk of developing trigeminal neuralgia increases significantly:

• over the age of 50;
• against the background of mental disorders;
• with regular hypothermia;
• with insufficient intake of nutrients and vitamins into the body (anorexia, bulimia, malabsorption, etc.);
• with regular overwork, stress;
• for helminthic infestations and other helminthiases;
• for acute infections: malaria, syphilis, botulism, etc.;
• for chronic inflammation in the oral cavity (caries, gingivitis, abscesses, etc.);
• against the background of autoimmune lesions;
• with excessive exposure to allergies;
• for metabolic disorders.

Symptoms

The main characteristic symptom of trigeminal neuralgia is paroxysmal pain. It comes suddenly and in its intensity and speed of spread resembles an electric shock. Typically, intense pain forces the patient to freeze in place, waiting for relief. The attack can last from a few seconds to 2-3 minutes, after which there is a period of calm. The next wave of pain may come within hours, days, weeks or months.

Over time, the duration of each attack of neuralgia increases, and periods of calm are reduced until a continuous aching pain develops.

The provoking factor is irritation of trigger points:

• lips;
• wings of the nose;
• eyebrow area;
• middle part of the chin;
• cheeks;
• area of ​​the external auditory canal;
• oral cavity;
• temporomandibular joint.

A person often provokes an attack when performing hygiene procedures (combing hair, caring for the oral cavity), chewing, laughing, talking, yawning, etc.

Depending on the location of the lesion, the pain takes over:

• the upper half of the head, temple, orbit or nose if the ophthalmic branch of the nerve is affected;
• cheeks, lips, upper jaw – if the maxillary branch is affected;
• chin, lower jaw, as well as the area in front of the ear - with neuralgia of the mandibular branch.

If the lesion affects all three branches or the nerve itself before it is divided, the pain spreads to the entire corresponding half of the face.

Painful sensations are accompanied by other sensory disturbances: numbness, tingling or crawling sensations. Hyperacusis (increased hearing sensitivity) may be observed on the affected side.

Since the trigeminal nerve contains not only sensory, but also motor pathways for the transmission of impulses, with neuralgia the corresponding symptoms are observed:

• twitching of facial muscles;
• spasms of the muscles of the eyelids, masticatory muscles;

The third group of manifestations of neuralgia are trophic disorders. They are associated with a sharp deterioration in blood circulation and lymph outflow. The skin becomes dry, begins to peel, and wrinkles appear. Local graying and even hair loss in the affected area is observed. Not only the scalp suffers, but also the eyebrows and eyelashes. Impaired blood supply to the gums leads to the development of periodontal disease. At the time of the attack, the patient notes lacrimation and drooling, swelling of the facial tissues.

Constant spasms of muscle fibers on the diseased side lead to facial asymmetry: narrowing of the palpebral fissure, drooping of the upper eyelid and eyebrow, upward movement of the corner of the mouth on the healthy side or drooping on the diseased side.

The patient himself gradually becomes nervous and irritable, and often limits himself to food, since chewing can cause another attack.

General information

Asymmetry of facial features is one of the consequences of strokes of ischemic and hemorrhagic etiology. The rehabilitation period takes a long period, the result of which may be complete or partial recovery. In some cases, distortion of facial expressions is difficult to treat. Therapy is prescribed by a neurologist after examination and determination of the cause of the defect.

Ischemic or hemorrhagic stroke is characterized by partial (prosoparesis) or complete (prosoplegia) loss of muscle activity, manifested in a sudden distortion of the face:

– on one side the eyebrow, corner of the eye or mouth is drooping;

– the nostril on the affected half of the face goes up;

– the facial oval and smile are distorted;

– when protruding the tongue, it points to the affected side of the face.

Diagnostics

A neurologist diagnoses trigeminal neuralgia. During the first visit, he carefully interviews the patient to find out:

• complaints: nature of pain, its intensity and localization, conditions and frequency of attacks, their duration;
• medical history: when pain attacks first appeared, how they changed over time, etc.;
• life history: the presence of chronic diseases, previous injuries and operations is clarified, special attention is paid to dental diseases and interventions.

A basic examination includes assessing the condition of the skin and muscles, identifying asymmetry and other characteristic signs, checking the quality of reflexes and skin sensitivity.

To confirm the diagnosis, the following is carried out:

• MRI of the brain and spinal cord with or without contrast: allows you to identify tumors, consequences of injuries, vascular disorders; sometimes the study is replaced by computed tomography (CT), but it is not as informative;
• electroneurography: study of the speed of nerve impulse transmission through fibers; allows you to identify the fact of nerve damage, assess the level of the defect and its features;
• electroneuromyography: not only the speed of impulse passage along the nerve bundle is studied, but also the reaction of muscle fibers to it; allows you to assess nerve damage, as well as determine the sensitivity threshold of trigger zones;
• electroencephalography (EEG): assessment of the bioelectrical activity of the brain.

Laboratory diagnostics includes only general studies to exclude other causes of painful attacks, as well as to assess the condition of the body as a whole (usually a general blood and urine test is prescribed, as well as a standard set of biochemical blood tests). If the infectious nature of the disease is suspected, tests are carried out to identify specific pathogens or antibodies to them.

Additionally, consultations with specialized specialists are prescribed: ENT specialist (if there are signs of nasopharynx pathology), a neurosurgeon (if there are signs of a tumor or injury), and a dentist.

Migraine

This condition is accompanied by attacks of unbearable headache. It is also associated with disruption of the trigeminal nerve, or more precisely, with its irritation in one part of the head. This is where the pain is subsequently localized.

The onset of migraine includes several stages:

• initial;
• aura;
• painful;
• final one.

Paresthesia of the head and face appears with the development of the aura stage. In this case, the patient is bothered by a feeling of tingling and crawling, which occurs in the arm and gradually moves to the neck and head. The person’s face becomes numb and it becomes difficult for him to speak. I am concerned about dizziness and visual disturbances in the form of light flashes, floaters and a decrease in the field of vision.

Facial paresthesia is a precursor to migraine, but often the attack occurs without the aura stage.

Treatment of trigeminal neuralgia

Treatment is aimed at:

• to eliminate the cause of damage;
• to alleviate the patient's condition;
• to stimulate the restoration of nerve structures;
• to reduce the excitability of trigger zones.

Properly selected treatment can reduce the frequency, intensity and duration of pain waves, and ideally achieve stable remission.

Drug treatment

Trigeminal neuralgia requires complex treatment using drugs from several groups:

• anticonvulsants (carbamazepine and analogues): reduce the excitability of nerve fibers;
• muscle relaxants (baclofen, mydocalm): reduce muscle spasms, improve blood circulation, reduce pain;
• B vitamins (neuromultivit, milgamma): stimulate the restoration of nerve fibers, have an antidepressant effect;
• antihistamines (diphenhydramine): enhance the effect of anticonvulsants;
• sedatives and antidepressants (glycine, aminazine): stabilize the patient’s emotional state.

For severe pain, narcotic analgesics may be prescribed. Previously, drug blockades (injecting the problem area with anesthetics) were actively used, but today this method of treatment is almost never used. It contributes to additional damage to nerve fibers.

Treatment of the root cause of the disease is mandatory: elimination of dental problems, taking medications to improve cerebral circulation, etc.

Physiotherapy and other non-drug methods

Non-drug methods complement drug therapy well and help stabilize patients’ condition. Depending on the condition and concomitant diseases, the following may be prescribed:

• ultraviolet irradiation: inhibits the passage of impulses along nerve fibers, providing an analgesic effect;
• laser therapy: reduces pain;
• UHF therapy: improves microcirculation and prevents muscle atrophy;
• electrophoresis with analgesics or antispasmodics to relieve pain and relax muscles;
• diadynamic currents: reduce the conductivity of nerve fibers, significantly increase the intervals between attacks;
• massage of the face, head, cervical-collar area: improves blood circulation and lymph outflow, improving tissue nutrition; must be carried out with caution so as not to touch trigger zones and provoke an attack; the course is carried out only during the period of remission;
• acupuncture: helps relieve pain.

Surgery

The help of surgeons is indispensable when it is necessary to eliminate nerve compression. If indicated, the following is carried out:

• removal of tumors;
• displacement or removal of dilated vessels pressing on the nerve (microvascular decompression);
• expansion of the bone canals in which the branches of the nerve pass.

A number of operations are aimed at reducing nerve fiber conductivity:

• exposure to a gamma knife or cyber knife;
• balloon compression of the trigeminal node: compression of the node using an air-filled balloon installed in close proximity to it, followed by death of the nerve fibers; surgery often leads to partial loss of sensation and decreased muscle movement;
• resection of the trigeminal node: rarely performed due to the complexity and large number of complications.

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Where is surgical treatment for paralysis of the facial muscles performed?

Specialists from the Department of Maxillofacial and Reconstructive Surgery of the Federal State Budgetary Institution NKCO FMBA of Russia, together with the Department of Ear Diseases, have developed and put into practice a unique method of surgical treatment of patients with paralysis of the facial muscles. The first operations on patients with this pathology in Russia were performed by specialists from the Federal State Budgetary Institution NCCO FMBA of Russia - otosurgeon, MD. Hassan Diab and maxillofacial surgeon Ekaterina Orlova.

A healthy person rarely thinks about how important facial expressions are and what role they play in our lives, especially a smile... Smile more often!

Complications

Without treatment, trigeminal neuralgia gradually progresses. Over time, a pathological pain focus forms in one of the parts of the brain. As a result, the pain covers the entire face, is provoked by any minor irritant and even the memory of an attack, and subsequently becomes permanent. Vegetative-trophic disorders progress:

• irreversible atrophy of the facial muscles is formed;
• teeth become loose and begin to fall out due to advanced periodontal disease;
• baldness is increasing.

Due to constant pain, the patient's sleep is disturbed and severe depression develops. In severe cases, patients may commit suicide.

Classification

Neuritis of the facial nerve can be primary or secondary.

The primary form of inflammation occurs as an independent disease in a healthy person due to hypothermia. This type of neuritis is called catarrhal neuritis.

The secondary form of inflammation develops against the background of infection, otitis media or another disease.

In the vast majority of cases, the disease is acquired, much less often it is congenital.

The congenital nature of the disease may be indicated by Melkersson-Rosenthal syndrome - swelling of the face combined with folding of the tongue.

Prevention

Prevention of trigeminal neuralgia is a set of simple measures that significantly reduce the risk of developing pathology. Doctors recommend:

• undergo regular preventive examinations;
• at the first signs of the disease, seek help (the sooner treatment is started, the greater its effect will be);
• eat right, get the required amount of vitamins, minerals, unsaturated fatty acids;
• regularly engage in light sports and gymnastics;
• get enough sleep and rest;
• minimize stress and physical overload;
• avoid hypothermia and harden yourself;
• to refuse from bad habits.

Treatment at the Energy of Health clinic

If you or your relative are bothered by severe pain in one or another part of the face, the neurologists of the Health Energy clinic will come to the rescue. We will conduct a full diagnosis to identify the causes of the pathology and prescribe comprehensive treatment. At your service:

• modern drug regimens to reduce the frequency and intensity of attacks;
• physiotherapeutic procedures: magnetotherapy, laser therapy, electrophoresis, phonophoresis, etc.;
• delicate therapeutic massage;
• acupuncture;
• help from a psychologist if necessary.

Advantages of the Health Energy Clinic

The Health Energy Clinic is a multidisciplinary medical center where every patient has access to:

• screening diagnostic programs aimed at early detection of diseases and pathologies;
• targeted diagnostics using modern equipment and laboratory tests;
• consultations with experienced specialists, including foreign ones;
• modern and effective comprehensive treatment;
• necessary certificates and extracts;
• documents and appointments for spa treatment.

Trigeminal neuralgia is a serious pathology that can seriously disrupt a person’s normal lifestyle. Don't let pain and fear take over your thoughts, get treatment at Health Energy.

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