Update: October 2018
Neuritis of the facial nerve – inflammation of the VII cranial nerve,
leading to a breach or loss of its function.
The facial nerve is a VII pair of cranial nerves, it innervates
facial muscles. As a rule, neuritis occurs with one
parties. At the same time there is paralysis of the facial muscles with
The facial nerve passes in its own canal in the skull, with
the occurrence of the inflammatory process appears his swelling, in
If the canal of the facial nerve is narrow, the nerve is trapped.
there that leads to disruption of his blood supply therefore
Causes of neuritis of the facial nerve
In most cases, the specific cause of neuritis of the facial nerve
impossible to install. Doctors distinguish only likely provocative
The trigger factors include:
- Local hypothermia. Sometimes it may be enough to sit
under the air conditioner or drive a car with an open window.
- Transmitted infectious disease, for example, acute
respiratory viral infection.
- Chronic inflammatory processes of upper respiratory tract, for example,
otitis, mesotympanic. Also the occurrence of facial neuritis may
contribute to the ongoing operations for purulent lesions of these
- Trauma (fracture or fracture) of the jaw or skull base.
- Systemic diseases, metabolic disorders.
There is a decrease in the reactivity of the organism, in this case the immune
the system can not cope even with mild inflammation.
Classification of facial neuritis
Primary neuritis is excreted, it results from
hypothermia, for example. Also emit a secondary, it occurs in
the result of already existing inflammation, for example, with otitis. Separately
It should be noted some forms of facial neuritis.
- Hunt syndrome – facial neuritis with shingles
Affection of the facial nerve is combined with other manifestations.
this disease, such as a characteristic rash on the tongue,
the mucous membrane of the oral cavity and pharynx, as well as in
auricle (see symptoms and treatment of shingles).
In this case, the herpes virus affects the ganglion, from which
The innervation is received by the hearing aid, the tonsils and the palate. Close to
This ganglion contains the motor branches of the facial nerve.
The disease begins with shooting pains in the ear, then
face asymmetry appears, reducing taste sensitivity
front third of tongue, dizziness, tinnitus and horizontal
- Neuritis in mumps (epidemic parotitis)
May be one-way or two-way. Accompanied by
fever, signs of intoxication and an increase in parotid
- Neuritis in borreliosis
There is always a bilateral lesion of the facial nerve.
Accompanied by подъемом температуры, эритемой и распространенной
- Neuritis with otitis
Symptoms of neuritis of the facial nerve in this case are accompanied by
ear pains that are acute. Infection with
middle ear contact falls on the branches of the facial nerve.
- Melkerson-Rosenthal syndrome
It is a hereditary disease that occurs sufficiently.
rarely, it is characterized by paroxysmal flow. During
exacerbations observed swelling of the face, neuritis of the facial nerve and
folding of the tongue.
The clinical picture of the disease – symptoms of neuritis
1 smooth lob2 it is impossible to close the eyelid3. lowered corner mouth4.
Facial neuritis develops slowly.
- At first, only pain behind the auricle may appear.
- After a few days, face asymmetry appears. Wherein
there is a smooth nasolabial fold on the affected side,
the omission of the corner of the mouth.
- Also, the patient cannot close his eyelids on the same side, and with
trying to make it manifest Bell’s symptom – the eyeball
- The patient cannot grin, smile, raise eyebrows,
Squish eyes, make lips a straw.
- On the affected side, the eyelids are wide open, the eyeball as
would be put forward (lagophthalmos). Symptom “hare eyes”
always present – visible white sclera band between
iris and lower lids.
Since the facial nerve has several beams, providing
sensitive innervation, there may be the following symptoms:
- taste loss on the front third
- dry eyes or, on the contrary, tearing
- Some patients have an interesting feature. With
dry eye begins tearing during meals
- Some patients have hyperacusia – the usual sounds
sound loud and overly harsh
Diagnosis of facial neuritis
As a rule, the clinical picture of the disease allows you to immediately
Unmistakably correct diagnosis. Additionally can assign
electromyography, evoked potentials or magnetic resonance
tomography to identify the underlying disease that could
cause the development of neuritis of the face (tumor, inflammatory
With неврологическом обследовании больного просят:
- screw up your eyes
- to lift eyebrows
- smile or bite your teeth
- as well as depict blowing out candles
With всех этих пробах наблюдается асимметрия лица и невозможность
Fully perform these actions. Also examine sensitivity
на передней трети language с помощью покалывания этой зоны. Are watching
is there tearing or dry eyes that helps determine
level of nerve damage.
Methods of treatment of facial neuritis
There are several important points about how to treat
neuritis of the facial nerve. If it is determined that there is a secondary
facial neuritis, treatment begins with the underlying disease,
caused the pathology of the nerves of the face.
- At the initial stage of the disease is recommended reception
glucocorticosteroids (prednisone, metipred, dexamethasone). They
effectively relieve inflammation.
- With выраженном болевом синдроме назначают нестероидные
anti-inflammatory drugs (movalis, nimesulide, see a list of all
NSAIDs in the article pain shots or pain ointment).
- Vasodilators are prescribed because at this
the disease has a malnutrition of the nerve, and this group
drugs can improve blood flow. These include aminophylline,
trental, agapurin, vazonit.
- Since the inflammation of the nerve is observed his swelling, which
aggravates the condition, it is necessary to use drugs,
reducing this swelling. To diuretics (diuretics)
include triampur, furosemide and others.
- Vitamins are used to improve metabolism in the nervous tissue.
Group B injections (combilipen, neurobion, unigamma).
- If movement disorders slowly regress, then
It is necessary to begin the introduction of anticholiesterase drugs, which
improve the process of neuromuscular impulse transmission, for example,
The treatment of neuritis is not limited to drugs, it is applied
many other auxiliary methods, among them physiotherapy,
massage, gymnastics, acupuncture and other non-drug
Physiotherapy in the treatment of facial neuritis
- Contactless use is possible from the first days of the disease.
thermal procedures such as soluks.
- From 5-6 days of illness, contact thermals can be applied.
procedures, for example, paraffin or ozokerite.
- UHF is also used after 5-6 days of illness.
- Ultrasound with hydrocortisone.
- The minimum course of physiotherapy is 8-10 procedures.
Massage and self-massage
Massage in case of neuritis of the facial nerves can be carried out as a specialist.
so is the patient himself. In the second case, you should know exactly how
do below is the technique of self-massage at this
- Put your hands on the face area, located in front of the ear
the sink. Massage and pull the muscles on a healthy half of the face.
down, and on the affected – up.
- Close eyes. Fingers massage the circular muscle of the eyes. On
the healthy side of the movement should go from above, outwards and downwards, and on
affected from the bottom up and from the inside out.
- Put index fingers on the wings of the nose on both sides.
On здоровой стороне делать поглаживания сверху вниз, а на
affected – on the contrary.
- Use your fingers to smooth the muscles in the corners of the lips. On
healthy side of the nasolabial fold to the chin, and on
affected – from chin to nasolabial fold.
- Onд бровями массировать мышцы в разных направлениях. On
healthy side to the nose and down, on the affected side – to the nose
With неврите лицевого нерва реабилитация может быть длительной и
often a similar method is used to achieve the fastest effect
These methods are not owned by all doctors, to carry out acupuncture.
can only be a specially trained doctor. Wherein в определенные
reflexogenic points on the face are introduced sterile thin needles,
which can cause irritation of nerve fibers. According to
Numerous studies in Asia and Europe, this method
perfectly proved itself in the treatment of this pathology.
Гимнастика при лицевом неврите делается несколько раз в
a day for 20-30 minutes. Do it in front of a mirror,
сосредоточившись на работе мимических мышц пораженной parties. With
doing exercises you need to hold your hand muscles on
healthy half of the face, because otherwise they can “pull” on
yourself all the load.
A set of exercises for facial neuritis
- Close your eyes tightly for 10-15 seconds.
- Как можно сильнее поднимите верхние веки и eyebrows вверх,
fix the position for a few seconds.
- Медленно нахмурьте eyebrows, зафиксируйте это положение на
- Try to inflate the wings of the nose slowly.
- Slowly inhale the air with your nose, while putting your fingers
on the wings of the nose and put pressure on them, resisting the flow
- Smile as wide as possible, try to have a smile
molars are visible.
- Smile broadly with your mouth shut and lips closed,
uttering the sound “and.”
- Put a small walnut on the affected side of the cheek and
try to talk like that.
- Onдуйте щеки и задержите дыхание на 15 секунд.
- Fold the tongue with a straw, cover the lips and slowly inhale and
exhale through the mouth.
- Move your tongue between your cheek and teeth in a circle.
If within 10 months from the start of conservative treatment there is no
effect, then you have to do autotransplantation. Usually take nerve
with the patient’s foot and hem it to the branches of the facial nerve on
the healthy side, and the other end is stitched to the muscles on the affected
to the side. Thus, the emerging nerve impulse causes
contract facial muscles on both sides at the same time. The
The treatment method is carried out no later than one year from the start.
diseases. Later, irreversible atrophy of facial muscles
на пораженной to the side.
Treatment of folk remedies
Onродные средства при неврите лицевого нерва мало эффективны и
can lead to deterioration and delay the disease.
Some use chamomile decoction compresses, dry heat or
rubbing ointment with herbs. All these methods are practically
not effective, so for help you need to contact
Prognosis and prevention
In most cases, with adequate treatment of the disease
cured completely. In some cases, there may be consequences in
виде скудной мимики на пораженной to the side. With отсутствии эффекта
from treatment after 3 months, the probability of complete recovery is dramatic
Disease prevention involves two main ways
Prevention of this disease:
- Avoid hypothermia and drafts.
- Timely and adequately treat inflammatory processes in
ear and nasopharynx areas
Автор: Ревус Олеся Григорьевна врач-невролог