How to treat the facial nerve. Inflammation of the facial nerve: initial symptoms - how to treat neuritis with folk remedies at home? Therapy with folk remedies at home

Neuritis (paresis, Bell's palsy) facial nerve causes dysfunction of the facial muscles. In most patients, the pathology affects one side. The appearance of neuropathy of the facial nerve is due to its damage or inflammation. The disease is characterized by a long course. When choosing a treatment, it is important to understand what paresis of the facial nerve is, and what causes the pathology.

What is facial neuritis?

To determine the reasons why neuritis develops, it is necessary to consider the anatomy of the facial nerve. The latter consists of the following elements:

• a site located in the cerebral cortex (regulates the movement of facial muscles);
• nerve nucleus;
• the nucleus of the facial pathway (regulates the work of taste buds);
• superior salivary nucleus (responsible for the work of the lacrimal and salivary glands);
• motor branches.

The facial nerve passes through the auditory canal and connects the muscles of the forehead, cheeks, eyes, nostrils, and mouth.

With neuritis, the impulses that the brain emits are disturbed. As a result, the pathology causes a decrease in the functionality of the muscles of the front of the head.

Classification

Depending on the cause, two types of neuritis of the facial nerve are distinguished:

• primary (occurs against the background of hypothermia);
• secondary (develops as a result of damage to the trigeminal nerve in various pathologies).

Paresis is also classified according to location into:

• peripheral;
• central.

With peripheral paresis of the facial nerve (Bell's palsy), only one side of the face is affected, which is due to inflammation of local tissues.

Such a lesion provokes a decrease in muscle tone. Inflammatory processes in the nerve fibers cause a narrowing of the channel through which they pass. This causes Bell's palsy.

With central paresis of the facial nerve, there is a violation of the functions of the muscles located below the forehead and eyes. This form of pathology occurs when brain tissue is damaged.

Approximately 10% of patients are diagnosed with congenital paresis. Light and middle form diseases of this type are treatable. In severe cases it is required surgical intervention.

The reasons

To date, factors that cause the development of pathology have not been identified. Researchers believe that, regardless of the form of facial nerve paresis, the causes of inflammation are due to the following factors:

Among probable causes the development of paresis isolate a violation of blood flow in the tissues of the face, which may be due to the following pathologies:

• ischemic stroke;
• hypertensive crisis;
• multiple sclerosis;
• diabetes;
• atherosclerosis.

Each of the factors listed above causes spasm or constriction of the capillaries. As a result, stagnation of blood occurs, due to which the arteries expand in some areas. The fluid, seeping through the walls of the capillaries, accumulates in the intercellular space, which leads to the formation of edema.

The described processes disrupt the blood flow in local tissues. Oxygen deficiency leads to swelling of the nerve trunk. Because of this, the transmission of nerve impulses from the brain to muscle fibers is disrupted.

Symptoms of the disease

With trigeminal neuralgia, symptoms occur rapidly. If such disorders develop slowly, then another disease serves as their cause.

Symptoms of neuritis of the facial nerve are as follows:

1. Pain radiating to the face or back of the head. The syndrome occurs 1-2 days before the first signs of facial expression disorder appear.
2. Facial asymmetry. Occurs mainly either on the right or on the left. In acute nerve neuropathy, the corner of the mouth drops and the eye opens wide. Symptoms become more pronounced during a conversation.
3. The eye from the side of the affected nerve does not close. When you try to close your eyes, a noticeable gap remains.
4. The cheek muscles stop responding to commands.
5. Dryness in oral cavity. Explained by dysfunction of the salivary glands.
6. Slurred speech. The symptom is due to the fact that only part of the mouth is involved in articulation.
7. Dry eye. Occurs against the background of dysfunction of the lacrimal glands. Also for this reason, some patients experience profuse lacrimation.
8. Violation of the perception of taste. Affects one half of the tongue.
9. Increased sensitivity to sounds.

With compression-ischemic neuropathy of the facial nerve, characterized by damage to the cerebral cortex, the following phenomena are observed:

• involuntary movement of the facial muscles;
• nervous tic;
• paralysis of the muscles of the lower part of the face.

Also, with paresis, patients have the following clinical symptoms:

• nystagmus (rapid and involuntary movements of the eyeballs);
• numbness of a part of the face;
• frequent twitching in the throat and in the palate;
• impaired coordination of one of the halves of the body;
• nervous deafness.

With neuritis of the facial nerve, the symptoms and treatment depend on the affected area. In particular, paralysis of facial muscles occurs due to damage to the cerebral cortex.

How to treat paresis of the facial nerve?

This pathology is treated by a neurologist. The disease is characterized by characteristic symptoms, so the diagnosis of neuritis of the facial nerve is often not carried out. However, in order to exclude other pathologies with similar clinical signs an additional examination is assigned, which includes the following procedures:

If neuritis is suspected, a complex is often prescribed. diagnostic measures, through which it is possible to establish the causative factor and the location of the inflammatory process.

Medical treatment

It is quite difficult to predict in advance how much neurosis is treated. The duration of therapy is influenced by the nature of the lesion, the degree of neglect, the cause of the pathology and other factors. If the causes of facial nerve paresis, symptoms are identified, and treatment is started in a timely manner, it takes about 6 months for the patient to recover.

In the treatment of pathology, an integrated approach is used. With neurosis of the facial nerve, treatment is carried out using various drugs, the selection of which is carried out taking into account causative factor. At the same time, medications are prescribed to relieve the symptoms of the disease.

With inflammation, drug treatment involves taking the following drugs:

Operational treatment

Paresis of the facial muscles (prosoparesis) is usually treated with medication. However, if this approach does not give positive results within 8-10 months, surgical intervention is prescribed. The operation is effective only in the first year. Later, irreversible changes occur in the muscles.

More often, operations are performed with compression-ischemic neuropathy of the facial nerve. Such disorders occur due to head trauma, which is not amenable to medical treatment. In addition, surgical intervention is indicated in case of nerve degeneration.

The tactics of the operation is determined depending on the nature of the damage. With a compression lesion, the incision is made behind the auricle. Next, the outer wall of the facial nerve canal is removed. As a result, the pressure on him disappears.

When the facial nerve is torn, an incision is made in the area where the problem is found. In case of serious damage, an autograft is placed. The latter is a nerve taken from the thigh. It is introduced into the area where the gap occurred. The femoral nerve is then sutured to the facial.

Physiotherapy methods

Physiotherapeutic procedures are prescribed 7-10 days after the onset of signs of neuropathy of the facial nerve. In the treatment of neuritis are used:

1. UHF low-thermal intensity. The method improves the nutrition of damaged tissues, relieves swelling. UHF stimulates the synthesis of leukocytes, which suppress the inflammatory process.
2. ultraviolet irradiation. UV by stimulating the synthesis of a number of hormones and immune cells has an anti-inflammatory effect.
3. Decimeter therapy. In the course of such exposure, the vessels expand, due to which the blood flow is accelerated and the nerve functions in the problem area.
4. Electrophoresis with a 0.02% solution of dibazol, a 0.1% solution of prozerin, potassium or vitamin B1. It has anti-inflammatory and analgesic effects. Electrophoresis eliminates tissue swelling.
5. Diadynamic therapy. The procedure is used to restore the contractile function of the muscles.
6. Paraffin or ozocerite applications. Stimulate the process of regeneration of damaged nerve fibers.

When applying physiotherapeutic methods of treatment, it is important to avoid hypothermia of the face. It is recommended not to leave the room for 15-20 minutes after each procedure.

Psychotherapy

Neuritis of the facial nerve negatively affects the mental state of the patient. The situation when polyneuropathy occurs is especially dangerous for a person. This disease is accompanied by multiple lesions peripheral nerves, which reduces the sensitivity of the face.

If treatment with sedative drugs does not improve the patient's condition, it is recommended to seek help from a psychotherapist. Otherwise mental disorders can accelerate the course of the disease and provoke the development of more severe complications.

Acupuncture and folk remedies

By conducting acupuncture procedures for neuritis of the facial nerve, noticeable improvements can be achieved. This method achieves the following results:

• eliminate inflammation;
• accelerate the recovery of damaged fibers;
• stop pain;
• get rid of paralysis of mimic muscles;
• eliminate accompanying phenomena.

Acupuncture helps restore muscle tone. It is allowed to resort to this method 5-7 days after the onset of symptoms of the pathology.

It is important to understand that only a doctor can determine how to cure neuritis. It is not recommended to engage in the restoration of the facial nerve on your own. This also applies to home treatment using traditional medicine methods. The latter can complement, but not replace, drug therapy.

In the treatment of pathology, the following folk remedies are used:

Treatment of pathology takes a long time. Therefore, the first results become noticeable no earlier than 10 days after the start of therapy.

Other treatments

To cure neuritis of the facial nerve, before the massage it is necessary to make several tilts and rotations of the head.

Manipulations should begin with the back of the head and neck. Then you can knead the skin on the healthy and affected parts of the face. In the early days, self-massage should be done with extreme caution, without pressing on the problem area.

To improve the flow of lymph, you need to run your fingers from the chin, nose and forehead to the auricles. In this case, areas where lymph nodes are located should be avoided. The procedure ends in the same way as it began: with a massage of the neck and back of the head.

• raise, frown eyebrows;
• smile, spreading your lips to the sides as much as possible;
• inflate nostrils;
• retract cheeks;
• lower the lower lip
• run your tongue across your lips from side to side;
• squint, close your eyes.

In other words, when performing exercises, it is necessary to involve all groups of facial muscles. These exercises should be repeated up to three times a day.

Complications of neuritis of the facial nerve

Not only paralysis occurs against the background of neuritis. The long course of the pathology causes the following consequences:

• amyotrophy;
• contraction of mimic muscles;
• blepharospasm, hemispasm (involuntary muscle twitching);
• facial synkinesis;
• inflammation of the conjunctiva of the eyes.

Neuritis is a fairly common pathology that gives severe complications. It is recommended to start treatment of the disease immediately after the onset of the first symptoms.

With this approach, the full restoration of the functions of the facial muscles takes an average of 6 months.

(Bell's palsy) is an inflammatory lesion of the nerve that innervates the mimic muscles of one half of the face. As a result, weakness develops in these muscles, leading to a decrease (paresis) or complete absence (paralysis) of facial movements and the appearance of facial asymmetry. Symptoms of neuritis of the facial nerve depend on which part of the nerve was involved in the pathological process. In this regard, there are central and peripheral neuritis of the facial nerve. A typical clinic of facial neuritis does not raise doubts about the diagnosis. However, to exclude the secondary nature of the disease, it is necessary to conduct an instrumental examination.

ICD-10

G51.0 Bell's palsy

General information

The facial nerve passes in a narrow bone canal, where it can be infringed (tunnel syndrome) during inflammatory processes or impaired blood supply. More prone to the occurrence of neuritis of the facial nerve are people with an anatomically narrow canal or structural features of the facial nerve. The cause of the development of facial neuritis can be hypothermia of the neck and ear, especially under the influence of a draft or air conditioning.

Classification

There are primary neuritis of the facial nerve, which develops in healthy people after hypothermia (catarrhal facial neuritis), and secondary - as a result of other diseases. Diseases in which neuritis of the facial nerve can develop include: herpes infection, mumps (“mumps”), otitis media (inflammation of the middle ear), Melkerson-Rosenthal syndrome. Perhaps traumatic damage to the facial nerve, its defeat in violation of cerebral circulation (ischemic or hemorrhagic stroke), tumors or neuroinfections.

Symptoms of neuritis of the facial nerve

Usually, neuritis of the facial nerve develops gradually. At the beginning there is pain behind the ear, after 1-2 days the asymmetry of the face becomes noticeable. On the side of the affected nerve, the nasolabial fold is smoothed out, the corner of the mouth is lowered and the face is warped to the healthy side. The patient cannot close his eyelids. When he tries to do this, his eye turns upward (Bell's symptom). Weakness of facial muscles is manifested by the inability to move them: smile, grin, frown or raise an eyebrow, stretch lips with a tube. In a patient with neuritis of the facial nerve, the eyelids are wide open on the diseased side and lagophthalmos ("hare's eye") is observed - a white strip of sclera between the iris and the lower eyelid.

There is a decrease or complete absence taste sensations on the front of the tongue, also innervated by the facial nerve. Dry eyes or watery eyes may occur. In some cases, a symptom of "crocodile tears" develops - against the background of constant dryness of the eye, the patient lacrimation occurs during meals. There is salivation. On the side of neuritis of the facial nerve, auditory sensitivity (hyperacusia) may increase and ordinary sounds seem louder to the patient.

Neuritis of the facial nerve in mumps is accompanied by symptoms of general intoxication (weakness, headache, aching limbs), fever and an increase in salivary glands (the appearance of swelling behind the ear). Neuritis of the facial nerve in chronic otitis occurs as a result of the spread infectious process from the middle ear. In such cases, paresis of facial muscles develops against the background of shooting pains in the ear. Melkerson-Rosenthal syndrome is a hereditary disease with a paroxysmal course. His clinic combines neuritis of the facial nerve, a characteristic wrinkled tongue and dense swelling of the face. Bilateral neuritis of the facial nerve occurs only in 2% of cases. Perhaps a recurrent course of neuritis.

Complications

In some cases, especially in the absence of adequate treatment, neuritis of the facial nerve can lead to the development of contractures of facial muscles. This can happen 4-6 weeks after the onset of the disease if motor functions facial muscles did not fully recover. Contractures tighten the affected side of the face, causing discomfort and involuntary muscle contractions. At the same time, the patient's face looks as if the muscles on the healthy side are paralyzed.

Diagnostics

The clinical picture of neuritis of the facial nerve is so bright that the diagnosis is not difficult for a neurologist. Additional examinations (MRI or CT of the brain) are prescribed to exclude the secondary nature of neuritis, such as tumor or inflammatory processes (abscess, encephalitis).

If the complete restoration of the facial nerve did not occur during the first 2-3 months, hyaluronidase and biostimulants are prescribed. When contractures appear, anticholinesterase drugs are canceled, tolperisone is prescribed.

Surgery

Surgical treatment is indicated in case of congenital neuritis of the facial nerve or complete rupture of the facial nerve as a result of trauma. It consists in suturing the nerve or carrying out neurolysis. In the absence of the effect of conservative therapy after 8-10 months and the identification of electrophysiological data on the degeneration of the nerve, it is also necessary to decide on the operation. Surgical treatment of neuritis of the facial nerve makes sense only during the first year, since in the future there comes an irreversible atrophy of the mimic muscles left without innervation, and it will be impossible to restore them.

Facial nerve plasty is performed by autotransplantation. As a rule, the graft is taken from the patient's leg. Through it, 2 branches of the facial nerve from the healthy side are sutured to the muscles on the affected half of the face. Thus, the nerve impulse from a healthy facial nerve is transmitted immediately to both sides of the face and causes natural and symmetrical movements. After the operation, a small scar remains near the ear.

Forecast and prevention

The prognosis of neuritis of the facial nerve depends on its location and the presence of concomitant pathology (otitis media, parotitis, herpes). In 75% of cases, a complete recovery occurs, but with a disease duration of more than 3 months, complete recovery of the nerve is much less common. The most optimistic prognosis is if the facial nerve is damaged at its exit from the skull. Recurrent neuritis has a favorable prognosis, but each subsequent relapse is more severe and prolonged.

Prevention of injury and hypothermia, adequate treatment inflammatory and infectious diseases of the ear and nasopharynx avoid the development of neuritis of the facial nerve.

Neuritis of the facial nerve (Bell's palsy) is an inflammatory process that involves one of the seven pairs of cranial nerves. At the same time, there are clear visible manifestations that warp and distort the face of the patient. Moreover, the affected side gets out of control, facial expressions suffer. So, a sick person cannot frown, move an eyebrow, and even smile normally. In addition, it is impossible to close the eye tightly, chew food normally, and even partially feel the taste.

The course of the disease manifests itself in a pronounced and visual form for others, which adds psychological suffering. In general, the reason for such a clinical picture during inflammation is associated with the passage of the nerve through the narrow channels of the bones of the face. So that even a slight inflammation leads to its clamping. As a rule, the inflammatory process captures one side, but in exceptional cases, which make up about 2.5%, a bilateral lesion occurs.

In general, neuritis of the facial nerve is a fairly common disease that occurs with a frequency of one case per 4,000 people. The time of risk is the cold season. Very often, a surge in incidence is associated with temperature fluctuations in a given area and a general decrease in people's immunity.

Neuritis is a disease that is protracted. You will have to stay in hospital for about a month, and for full recovery a whole semester may be needed. But, unfortunately, such paralysis is prone to recurrence in more than 10% of common cases. The general condition and prognosis depends on how deeply the nerve is damaged, one or two-sided damage is observed, as well as the fact that treatment was started quickly and comprehensively.

The facial nerve itself undergoes a number of bends and overcomes a large number of small openings. So, it passes through the temporal bone, the internal auditory canal and the parotid gland.

With inflammation, the nerve swells and it is clamped in these small passages, which entails all the visual symptoms that characterize this disease.

Why does the facial nerve become inflamed?

The inflammatory process can be caused by many factors. Let's look at the most common ones.

1. specific viruses. Many viruses, entering the body, do not manifest themselves at first. But, under favorable conditions, their active reproduction occurs. The virus that is one of the main culprits of neuritis is, known to many, the herpes virus. In addition, it is believed that mumps, polio, and some others can also be pathogens.
2. Unfavourable conditions. It was observed that the highest number of cases is observed in the northern regions. Local and permanent general hypothermia leads to a decrease in immunity, vasospasm and a change in the nutrition of tissues and the nerves themselves, thus provoking the clinical manifestations of neuritis.
3. Constant and large doses of alcohol. Alas, alcohol addiction and the intoxication caused by it have a detrimental effect on many systems and organs. Nerves are no exception. Thus, inflammation is provoked. Moreover, as a rule, such patients come with already advanced cases and are not inclined to painstaking therapy.
4. Hypertension. Changes in pressure, hemorrhages - all this affects the trophism, therefore, it can lead to clamping and neuritis.
5. Pregnancy. Hormonal changes have a strong effect on the entire body, and on the nervous system in particular. Therefore, there may be violations that can cause an inflammatory process.
6. Some traumatic brain injuries and ear injuries. In case of injury, rupture of nerve fibers and edema can occur, and as a result, an inflammatory process that already captures most of the nerve.
7. Otitis, sinusitis, unsuccessful dental intervention. All this can contribute to the spread of inflammation to nearby tissues, which can cause nerve compression.
8. Stress, depression, long-term chronic diseases. All this can undermine the overall strength of the body.
9. Neoplasms. They are capable of both involving the nerve itself in the inflammatory process, and simply mechanically acting on it, causing compression and a change in nutrition.
10. Multiple sclerosis and atherosclerosis. They affect the condition and integrity of the nerve itself and can cause its change and inflammation.
11. Diabetes. Affects the general condition of the body and contributes to the occurrence of foci of inflammation.

Symptoms and Diagnosis

Neuritis always begins acutely and is characterized by:

• pain behind the ear, radiating to the back of the head or face, the sensation may also extend to the eye;
• there is a distortion of the face, the muscles do not control the affected side;
• the eye of the affected side does not close tightly, forming a gap through which the protein is visible, which is called the "hare's eye";
• the corner of the mouth on the affected side drops, liquid food is partially poured out because of this;
• the full ability to chew food is violated, although the jaws are under control, the food falls behind the cheek, and the patient constantly bites it;
• the signals entering the brain from the salivary gland are distorted, so it can occur as constant feeling thirst, as well as increased salivation, and the flow of saliva formed from the uncontrolled side;
• uncontrollable cheek leads to fuzzy speech;
• tearing changes: the eye may dry out or, conversely, too much tears are released, and it constantly flows from the uncontrolled side;
• part of the tongue on the affected side ceases to feel the taste;
• there may be increased irritability loud sounds and the perception of some everyday and familiar sounds as loud and annoying.

To suspect a disease, it is worth carrying out not cunning manipulations:

• frown;
• puff out cheeks;
• take water in your mouth;
• smile symmetrically;
• raise eyebrows in surprise
• wrinkle the forehead and nose;
• blink alternately;
• close both eyes tightly (assessed by another person).

If, when performing these tasks, you notice that one side of the face falls out of the process and is not controlled by you, contact your doctor immediately.

With a less vivid clinical picture or for additional confirmation, various studies may be prescribed, for example, electroneurography and electromyography. The essence of the research is to detect a distorted transmission of nerve impulses (its decrease or absence). Thus, the diagnosis is specified, it is assumed which area is inflamed and how strong and extensive the inflammation is.

Treatment

Medical therapy

It is worth noting that only the attending physician should prescribe treatment, taking into account the peculiarities of the course of your case. Self-medication can lead to disastrous and irreversible consequences. This is just a general outline.

1. Diuretic drugs remove excess fluid, freeing the nerve from severe squeezing.
2. Non-steroidal anti-inflammatory drugs, as the name implies, relieve inflammation and reduce pain.
3. Glucocorticoids relieve inflammation and pain, but most importantly, they prevent the formation of contractures (tightening of facial muscles).
4. Antivirals stop the virus from dividing.
5. Antispasmodics reduce spasm, improve nutrition and blood circulation, and reduce pain.
6. Neurotropic drugs improve the functioning of nerve cells, reduce tics and contractions, and relieve pain.
7. B vitamins play an important role in the normal functioning of the nervous system, help it cope with toxins and recover.
8. Anticholinesterase agents normalize the function of the salivary and lacrimal glands improve signal conduction.

Physiotherapy and massage

However, drug treatment must necessarily be combined with physiotherapy and massage. Massage should be started on the 5-7th day, and physiotherapy - not earlier than on the seventh day of the onset of the disease. Remember that with these types of therapy it is worth avoiding hypothermia in general and especially the first 20 minutes after its use. If the disease occurs in the autumn-winter period or early spring, be sure to wrap the affected side in a scarf or hood. It is advisable to avoid walking, and the first fifteen minutes after the session - you should not go outside at all.

Some of the most common physiotherapy procedures are:

• • UHF, which helps to improve tissue trophism, reduce inflammation by increasing the number of leukocytes;
  • UV, which promotes the production of immunoglobulins, reduces pain and inflammation;
  • UHF, which raises the temperature in the affected area, dilates blood vessels, restores blood circulation and restores impaired nerve function;
  • electrophoresis, which has a decongestant and analgesic effect, and also helps to introduce medicinal substances into the lesion, achieving their high concentration in the right place;
  • diadynamic therapy, which promotes muscle contraction and their kind of "charging" for better recovery and exclusion of complete paralysis or incomplete recovery;

Acupuncture is a separate item. Properly performed, such a procedure can reduce swelling and improve the general condition of the patient, leading to a speedy recovery. However, it is not superfluous to recall that this manipulation should be carried out exclusively in medical institutions. Beware of acupuncture that is done privately without proper permission. In this case, you can face the opposite effect and, moreover, have all the consequences of using non-sterile material.

Massage for neuritis is of great importance, as it prevents the development of contracture and atrophy of the muscles of the affected area. Better to have it done by a professional. At least the first sessions, until you understand its intricacies. In the future, massage can be carried out independently.

Massage begins with a warm-up of the neck muscles. If you carry out the procedure yourself, it is enough just to tilt your head in slow mode in all directions. Then they begin to knead the back of the head. After all, the lymph nodes of this area will receive additional lymph that has accumulated in the area of ​​​​the face, in the place of edema. Massage is carried out both on the affected and healthy area. The procedure itself should be superficial in order to avoid painful sensations from strong muscle contraction. Direct location lymph nodes no need to massage. This can provoke too much exacerbation of the process. Finishing the massage is the same as it started: the neck and neck area is massaged. On average, the procedure takes 15 minutes.

You can independently develop the cheek area: pulling it away, grabbing it with your fingers with inside. So her sensitivity gradually returns.

Folk remedies

Folk wisdom has accumulated a lot of experience in the fight against this disease. But, taking into account the experience of ancestors, be sure to consult with your doctor about how suitable the chosen method is for you. Do not forget that, as a rule, such therapy begins no earlier than a week from the onset of the disease.

The most common means are warming up. One of these methods is dry heating with the help of sea / table salt or sand. The point is that a small amount of this material is heated to a pleasant (not hot, but warm) temperature, folded into a cotton bag and applied to the affected area for heating. If you take a pharmacy sea ​​salt, saturated with minerals and natural additives (for example, chamomile or lavender oil), then an additional effect is achieved useful influence components for the regeneration of the damaged area.

Chamomile can also be used alone. Pharmaceutical collection (preferably packaged) is brewed in a cup, according to the instructions. The broth is drunk, and warm bags are applied to the site of inflammation under the film and insulated from above with a scarf. Application time -15 minutes. In addition to warming up, chamomile has a powerful anti-inflammatory and immune-boosting effect. In addition, such a decoction at night has a slight calming effect. After all, a person is often very worried about his condition and can sleep poorly. If the chamomile is not in a bag, but a dry product, the contents for heating should be folded into gauze.

Complications with improper therapy

If therapy is not started on time or is not carried out rationally, the most serious consequences are possible. Such as:

• • • muscle atrophy, which occurs about a year after the onset of the disease: the muscles seem to “dry out” from inactivity and it turns out, alas, irreversible process deformations;
    • contracture of facial muscles, which can occur about a month and a half after the onset of the disease: the muscles “tighten”, shorten, there is a painful pulsation and a kind of face distortion (squinted eye, nasolabial fold becomes clearly visible);
    • involuntary twitching of the muscles of the face may occur due to incorrect impulses;
    • synkinesis, which is characterized by incorrect transmission of nerve impulses, as a result of which the excitation of one zone may be incorrectly transmitted and spread to others, thus, for example, “crocodile tears” are obtained, when the lacrimal gland is irritated when chewing;
    • conjunctivitis or keratitis, which develops due to loose closing of the eye and the corresponding drying out.

In an exceptional case, if therapy is ineffective in the first 8-10 months of the disease, surgical intervention is possible to prevent irreversible consequences caused by atrophy.
But, it is better to seek treatment on time. Also, it's important not to give up. Many patients, seeing that the results do not come so quickly, despair and stop attending physiotherapy and massages. This is what becomes a turning point, and therapy is delayed. Therefore, it is important to continue all appointments and motivate yourself to recover. And also make every effort to prevent hypothermia in the future and maintain your immunity.

Competent therapy of the disease will allow not only to immediately eliminate the symptoms, but also to avoid the recurrence of such conditions and complications in the future.

Methods for the treatment of inflammation of the trigeminal nerve

Intense pain that suddenly occurs on the face, head, temples, jaw makes a person look for means to eliminate the symptoms of inflammation of the facial nerve. In such situations, self-treatment can lead to negative consequences - you need to contact a medical institution. Treat inflammation trigeminal nerve the doctor should.

Today, it is accepted to effectively treat inflammation of the trigeminal nerve by several methods:

Most often, conservative methods of therapy are used. Only in exceptional situations where it is impossible to eliminate painful symptoms medicines and physiotherapy procedures, they resort to surgery. In this case, the doctor eliminates the compression of the nerve fiber or destroys the nerve that causes pain.

Modern approaches to the treatment of inflammation of the facial nerve allow us to solve several problems. First of all, the doctor prescribes medications that reduce painful symptoms. The next stage of treatment is to eliminate the factors that provoked neuralgia. The final phase of therapy should include prophylactic drugs against the occurrence of repeated attacks of inflammation of the trigeminal nerve on the face.

Medicines for pain and inflammation

Most Popular medications for the treatment of trigeminal neuralgia - anti-inflammatory and analgesic drugs. Typically, these drugs are prescribed in short courses. They help reduce inflammation and pain.

Nimesulide (Nimesil, Nemulex, Nimika, Nimulide) is one of the most effective means. The drugs quickly stop the pain, reduce the severity of the inflammatory process. The duration of therapy is from three to seven days. Nimesulide is used orally or as an ointment.

Diclofenac (Ortofen, Voltaren, Diklak, Dicloberl) in the form of ointments, gels is applied topically to relieve moderate pain. In the form of injections, tablets and capsules, it reduces trigeminal inflammation and facial pain.

Preparations that include ibuprofen (Ibuprom, Nurofen) eliminate the symptoms of pain and inflammation. The drug has a pronounced efficacy and low toxicity. Ibuprofen is available in the form of tablets, capsules and ointments.

Less commonly, a doctor may prescribe katadolon, xefocam, dexalgin, ketorolac to eliminate pain. Injections of analgin with diphenhydramine help to quickly relieve the symptoms of pain, swelling and inflammation.

Sometimes it is not possible to cope with recurring attacks of neuralgia on the face with conventional non-steroidal painkillers. Increasing the dose of drugs only increases their toxicity and severity of side effects. In order to solve this problem, the doctor may prescribe medications that relax muscles - muscle relaxants.

Any pain provokes a spasm. This worsens the blood supply. painful area on the face, jaw, head. Poor blood supply aggravates the situation, pain and spasm only intensify. To break this circle, along with non-steroidal painkillers, the doctor recommends the use of muscle relaxants (tolperisone or tizanidine).

The use of muscle relaxants along with non-steroidal painkillers speeds up recovery, effectively helps to cope with pain. In addition, due to the joint use of tolperisone or tizanidine with anti-inflammatory drugs, it is possible to reduce the dose of painkillers.

Anticonvulsants

Drugs with an anticonvulsant effect eliminate the symptoms of inflammation of the trigeminal nerve. Carbamazepine, Gabapentin, Clonazepam, by inhibiting the transmission of pathological impulses in nerve endings, help to reduce the number of pain attacks that occur. Anticonvulsant drugs are prescribed only by a doctor, individually selecting the dose, frequency and duration of the drug.

Carbamazepine, Clonazepam and Gabapentin act gradually. The course of therapy can take from several months to six months. With the help of anticonvulsants, it is possible to successfully treat inflammation of the trigeminal nerve and achieve partial or complete elimination of the symptoms of the disease.

Drugs to eliminate the causes of neuritis

Inflammation of the trigeminal nerve is difficult to cure if you do not deal with the elimination of the factors that triggered the development of the disease. Infectious diseases, injuries, nervous disorders, mechanical compression of nerve fibers provoke the appearance of pain in trigeminal neuritis.

Deal with herpes or colds can be done with antivirals. Interferon and acyclovir preparations suppress the development of the herpes virus, which affects nerve fibers and causes pathology of the facial nerve.

Eliminate painful sensations on the face that appear when stressful situations, sedative drugs and B vitamins help. It is optimal if sedatives(afobazole, glycine, phenibut, mebicar) is prescribed by a doctor.

Medicines containing B vitamins (milgamma, combilipen, neurobion, neuromultivit) help restore the normal functioning of nerve fibers.

Sometimes the disease of the trigeminal nerve is provoked by sinusitis, sinusitis, allergies or dental pathologies. In such situations, it is important to treat these ailments in a timely manner and seek medical help. Antibacterial drugs, antiallergic agents may be prescribed.

To treat the pathology of the facial nerve, drugs that improve activity are also used. blood vessels. If the disease is caused by atherosclerosis, cholesterol-lowering drugs must be prescribed: simvastatin, atorvastatin, rosuvastatin, fenofibrate. Sometimes medicines are recommended that optimize the blood circulation of the brain: vinpocetine, ginkgo biloba, piracetam, cinnarizine, betahistine.

Auxiliary therapies

In order to quickly eliminate the symptoms of the disease, it is necessary to adhere to an integrated approach to treatment. Medicines can be used not only in the form of injections or tablets. Various physiotherapy procedures are more effectively carried out using medications.

Non-steroidal anti-inflammatory drugs (analgin, diclofenac), antispasmodics (drotaverine, magnesium sulfate) are successfully used for electrophoresis in case of damage to the trigeminal nerve. Compresses with dimexide, painkillers, glucocorticoids (hydrocortisone, prednisolone, dexamethasone) help to eliminate pain and inflammation at home.

As additional funds can be used medicinal plants. Medicinal herbal teas, baths with herbs and essential oils help to calm the nervous system and restore health.

Many experts tend to believe that inflammation of the facial nerve is almost impossible to cure. At the same time, today the doctor has a solid arsenal of tools and can prescribe an effective drug treatment for inflammation of the trigeminal nerve. Complex therapy can prevent the occurrence of painful attacks of neuralgia of the facial nerve for a long time.

Facial nerve: symptoms and treatment of neuralgia (neuritis)

Facial neuralgia is an unpleasant disease, as the symptoms are reflected on the face, and the treatment is not always effective. Even long-term medication does not always cure neuritis.

In medical language, neuralgia of the facial nerve is defined as a recurrent disease with repeated symptoms, exacerbations, remissions, characterized by bouts of severe pain, damage to the facial muscles due to the pathology of the facial nerve.

Pain syndrome occurs more often in the exit area of ​​the 2nd, 3rd branch. Rarely, the symptoms of nosology can be traced in the projection of the 1st branch. The first description of the disease belongs to a Venetian doctor. In 1550, he singled out an independent nosological form arising from neuritis of the facial or trigeminal nerve. According to ICD-10, the disease has several names:

1. Atypical facial pain;
2. Paroxysmal facial pain;
3. Unspecified lesion of the trigeminal nerve;
4. Trigeminal neuralgia.

Facial nerve: anatomy, pathophysiology

The facial nerve enters the surface of the face through certain openings. It is located in a narrow channel, where it can be infringed. The condition is called "tunnel syndrome". In inflammatory processes, inflammation is nonspecific. Causes swelling, compression of nerve fibers.

Pathological symptoms are also formed due to compression of the branches by sclerotic plaques, tumors, neoplasms. There are cases of nonspecific neuritis (inflammation of the nerve).

The cause of neuritis in rare cases is an atypical anatomy:

We should not forget about etiological role the herpes virus, which is present in the blood of more than 90% of the population, but the disease is activated when immunity is reduced.

About half of the cases of damage to the facial nerve can not be established. Pathophysiology speaks of many idiopathic cases of the disease in which the etiological factor cannot be established. There are combined forms.

Mimic muscular symptoms in facial neuritis

Symptoms of damage to the facial muscles are present in the disease quite often due to the innervation of the facial muscles by the fiber.

The innervation of the facial muscles is provided mainly by the facial nerve. True, the sensitive function of the fiber cannot be excluded, since taste and secretory fibers, the constituent elements of the intermediate nerve, pass through its thickness.

Given the facts described, it will not be difficult to determine the symptoms of neuralgia of the facial nerve - paralysis of facial muscles. Neurologists distinguish central and peripheral paralysis, which determine the main signs of pathology.

Symptoms of central paralysis of facial expressions

It is combined with immobility of both lower limbs on the opposite side, as it occurs due to damage to the fiber above the motor center. The cause of the condition is a cerebral stroke, when oxygen delivery to the brain tissues is disrupted due to hemorrhage.

Signs of peripheral paresis of the facial nerve

Weakness of facial expressions on one side of the face due to damage to the motor nucleus develops at the level of the lesion in the interval from the exit from the stylomastoid process temporal bone to the motor nucleus of the brain. Signs of a complete loss of facial dynamism, the inability to fully display emotion are a typical sign of peripheral paralysis.

Specific symptoms of neuralgia of the facial nerve

When studying the facial or trigeminal nerve, neuropathologists are guided by the following symptoms:

1. Miyar-Gubler - unilateral lesion of the lower part of the bridge and the facial nucleus is accompanied by a cortical-spinal blockade with paresis of the mimic muscles on the side of the lesion (hemiplegia, hemiparesis);
2. Cerebellar pontine angle syndrome is formed in the presence of a tumor (neurinoma) in the area of ​​the vestibulocochlear nerve. The facial nerve passes through this area. The condition provokes otoneurological symptoms, which we will discuss below;
3. Fauville - unilateral lesion of the facial and efferent fibers in stroke. The defeat of facial expressions occurs on the side of the damage. In pathology, the work of the external oblique muscle of the eye is always disrupted;
4. Fallopian canal syndrome is formed due to the narrowing of the lumen of the canal of the pyramid of the temporal bone, which, on the one hand, exits at the bottom of the auditory canal, and on the other, opens with the stylomastoid foramen. The facial nerve exits through it. Symptoms are variable - from paralysis of facial muscles, to lacrimation, dry eyes, taste disorders of the anterior part of the tongue.

Otoneurological symptoms in lesions of the facial nerve

Otoneurological symptoms of neuralgia of the facial nerve develop when a fiber is damaged in the region of the pyramid of the temporal bone. The condition is accompanied not only by severe hearing loss on the one hand. Along with it, severe facial pain (trigeminal) is formed. Attacks occur acutely, do not go away for a long time. After a period of imaginary well-being, a relapse of the disease occurs.

Self-cessation of the attack is variable - from several minutes to several days. Most patients treat trigeminal neuralgia with anticonvulsants. The drugs well eliminate trigeminal pain. The symptomatology of the disease undergoes changes due to the disappearance of an attack of pain in the peak phase, but the inflammatory process in neuritis persists.

The second variant of the disease is non-paroxysmal prosopathy, characterized by facial pain, a deficit in the nervous sensitivity of the face. Such neuralgia is combined with anesthesia, hypesthesia (reduced or hypersensitivity). The form is often provoked by a virus herpes simplex, sarcoidosis, Lyme disease (tick-borne encephalitis).

Another form of facial neuralgia is traumatic neuropathy. Clinical symptoms:

• non-paroxysmal pain;
• Feeling of numbness of the limbs;
• mimic disorders;
• Sensory insufficiency - a decrease in the sensitivity of the face on the side of the lesion.

Postherpetic neuralgia occurs after the treatment of rashes in the projection of the corners of the mouth, the mucous membrane of the cavity, which is provoked by the herpes simplex virus. The form occurs in people over 60 years of age. The following factors contribute to the appearance of the disease:

• Herpetic eruption with capillary bleeding;
• Secondary pathology against the background of the disease;
• Acute herpes with late qualified treatment;
• Sensory deficit - numbness of the skin of the face.

Symptoms of the herpes simplex virus are not associated with neuritis. The combination of pathologies develops in the elderly against the background of a decrease in immunity.

Trigeminal Neuralgia: Trigeminal Pain Syndrome

Trigeminal pain syndrome worries patients with neuralgia for a long time. There are the following types of clinical form:

1. Separate attacks with a "light" interval;
2. Short-term shooting pain lasting about 10 seconds;
3. Increased soreness with irritation of the trigger zones - projection of the exit of the 2.3 branches of the facial nerve;
4. Extended pains in the area of ​​the exit of the branches of the facial nerve with periods of remission and exacerbation;
5. Pain syndrome arising under the influence of triggering mechanisms - washing, swallowing, talking, chewing, wind action;
6. Avoidance of irritation of trigger zones by a person indicates the possibility of a pain syndrome;
7. Freezing a person in one position, avoiding facial expressions, screaming and crying to prevent the onset of pain;
8. Twitching of mimic muscles against the background of a painful attack;
9. Lack of sensation in the area of ​​pain.

Manifold clinical symptoms does not complicate the diagnosis, since there are specific signs of pathology. It is enough to press your fingers on the exit points of the 2nd, 3rd branches to increase the pain syndrome.

Separate clinical form neuralgia is a phobic syndrome. It develops as a result of the protective behavior of the patient. A person gets used to avoid facial irritation, to provoke pain by the activity of facial muscles.

Expanded clinical attacks of pain with periods of exacerbations, remissions continue in patients for several years. Intensify manifestations of toothache, sinusitis. Caries, inflammation of the paranasal sinuses increase the manifestations of nosology, exacerbate the course, provoke regular bouts of pain. Nosological forms are not comparable with neuralgia, so they need to be treated immediately after the onset. However, patients with long-term facial neuritis are familiar with the information in practice.

Paroxysms of trigeminal pain are medically called neuralgia. Non-paroxysmal views on the face often provoke "trigeminal neuropathy." An exception is non-paroxysmal pain syndrome in herpes infection. It is called neuralgia.

Differential diagnosis of the condition is necessary, since the treatment of nosological forms is different.

Facial neuritis - what is it

Facial neuritis is inflammatory disease. Provoked by infectious factors. The disease rarely (2%) may be accompanied by a bilateral lesion of facial expressions.

The special location of the facial nerve in the canal of the temporal bone provokes the infringement of the nerve fiber at any pathological process accompanied by narrowing of the lumen. During inflammatory processes, fluid accumulates in the cavity, edema occurs.

A unique form of facial neuritis is Hunt syndrome. Occurs with a herpetic lesion of the ganglion, which provides innervation of the auricle, tonsils, palate, and tympanic cavity. The inflammatory process in herpes often affects the facial nerve, which provides specific symptoms facial neuritis:

• severe ear pain;
• Hearing loss;
• Dizziness;
• Horizontal nystagmus;
• Pathology of taste perception by the anterior part of the tongue;
• Irradiation of pain in the neck, neck.

Facial neuritis occurs with mumps (inflammation of the parotid glands). Symptoms of such a nosology are more localized: an increase in salivary glands, fever, intoxication, hearing loss.

Facial neuritis can occur when an infection spreads from the middle ear in a chronic inflammatory process. Ear swelling develops due to an increase in the salivary glands.

With such a nosology, the likelihood of paresis of facial muscles increases, shooting pains in the inner ear.

Neuralgia of the facial nerve: treatment

Treatment of facial neuritis requires relief of all symptoms of pathological conditions. There are standard schemes for eliminating pathology.

Most neuralgias are treated with non-steroidal anti-inflammatory drugs. Medicines eliminate trigeminal facial pain. With a strong pain syndrome, the use of amitriptyline, gabapentin, carbamazepine is recommended.

Preparations for the treatment of facial neuritis:

• Carbamazepine is an affordable, effective drug for the treatment of trigeminal neuralgia. The maximum effect of the drug is expressed at the initial stage of the disease. Carbamazepine is indicated for severe pain. The daily dose of the drug for exacerbation of the symptoms of facial neuritis is mg. For achievement therapeutic action Three times a day is enough. With the progression of neuralgia, long-term maintenance doses of carbamazepine are required;
• Gabapentin is indicated for paroxysmal pain as an alternative to carbamazepine. The drug belongs to the category of anticonvulsants with analgesic action. The drug is popular for non-paroxysmal and paroxysmal forms of trigeminal neuralgia. Daily dosage drug - mg. The drug is considered safer than amitriptyline and carbamazepine;
• Amitriptyline is a tricyclic antidepressant. The mechanism of action of the drug is a blockade of the reuptake of serotonin and norepinephrine, which inhibits the transmission of a nerve impulse. The anesthetic effect of the drug is achieved after 2 weeks. To reduce anticholinergic and sedative effects recommended daily dosage. If amitriptyline does not work properly, Gabagamma (gabapentin) is required.

For increase therapeutic effect of the above funds, it is recommended to use drugs of group B - “milgamma compositum”. The combined composition relieves local irritation of nerve fibers. Structural Components milgamma:

Specialists explain the therapeutic activity of milgamma by the inhibition of nocioceptive impulses. When using the drug, there is an acceleration of the restoration of the myelin sheath. Treatment is carried out intramuscular injections 2 ml daily. The duration of therapy is about 2 weeks. Then, for 6 weeks, "milgamma compositum" should be taken orally - three times a day, 1 tablet.

Some European sources consider carbamazepine to be the only effective drug for neuralgia, which reduces the permeability of the neuron membrane.

One of the international trademarks of carbamazepine is tegretol. The drug has both a psychotropic and anticonvulsant effect. The drug suppresses paroxysmal pain. Recommended for autonomic symptoms and mental disorders.

The main purpose of tegretol is the treatment of symptoms of epilepsy. Contraindications to the appointment of funds:

• epileptic seizures;
• atrial blockade;
• Hyponatremia.

Treatment of neuralgia with the drug is carried out according to the doctor's prescription. Without a prescription, the medicine is not sold in a pharmacy.

Phenytoin for the relief of pain, 3 tablets per day. A contraindication to treatment is impaired renal function, cardiac arrhythmias, cachexia, renal and hepatic failure. Side effects drug:

• Porfiria;
• cardiac arrhythmia;
• cachexia;
• Renal and hepatic insufficiency.

To increase the therapeutic effect, it is better to use phenytoin in combination with clonazepam, carbamazepine, valproic acid.

With exacerbation of neurological manifestations, the use of acupuncture, laser exposure, ultraphonophoresis is recommended. Pain syndrome on the background of neuralgia is eliminated by taking antispastic drugs - muscle relaxants. Sirdalud, mydocalm relax the muscles, which relieves nerve compression caused by the infringement of the fiber inside the muscle fibers. Sirdalud also inhibits polysynaptic transmission of the nerve signal.

With low efficacy of drugs, neurosurgical methods of therapy are recommended - decompression of the trigeminal nerve, retrogasseral thermorhizotomy.

Physical methods of treatment of neuralgia of the facial nerve

Simultaneously with conservative drugs for the treatment of neuralgia of the facial nerve, physical methods are recommended:

• For 15 minutes, take a position with a bowed head while maintaining it with the back of the hand;
• Sleep on the affected side;
• pull up healthy muscles faces in the direction of the lesion by tying a handkerchief. The method helps to restore facial symmetry.

Instead of a handkerchief, adhesive tape tension is used to correct asymmetry. On the first day, the procedure is recommended for 1 hour 2-3 times a day. Together with the patch, facial exercises should be performed.

For the healthy side, a gradual dosed contraction and relaxation of the muscles is applied. Specialists prescribe complexes of post-isometric physical education. Isolated tension and contraction of individual muscle groups can normalize laughter, loss of speech activity, which are often disturbed in patients with facial neuralgia. It is usually recommended to perform exercises twice a day.

Massage is aimed at stimulating healthy mimic muscles, the collar zone. According to the classical method, a combination of several massage exercises should be used:

You should not resort to active massage, so as not to provoke an exacerbation of pathological symptoms.

• Acupuncture;
• Postisometric relaxation;
• Neurostimulation;
• Electrophoresis on the area of ​​pathological nerve impulses.

European recommendations for neuralgia of the facial nerve - the use of alpha-lipoic acid. According to the results of many clinical studies, the use this drug accelerates the restoration of nerve membranes. The drug has proven effective in Bell's palsy. There are practical studies regarding the benefits of the remedy for facial neuritis.

Of the cosmetic procedures for the treatment of pathology, some cosmetology private clinics use botulinum toxin preparations. The tool allows you to restore the muscles. When conservative treatment does not require effectiveness, surgical treatment is possible to decompress the fiber.

Causes of trigeminal neuralgia, symptoms and treatment at home, medically and surgically

The nervous system plays a vital role in the functioning of the human body. It is responsible for almost all processes, including facial expressions, speech, and the function of chewing food, so trigeminal neuralgia can cause problems with masticatory muscles, severe pain, and facial muscle spasms. What makes it appear this pathology, and what methods of treatment exist?

Possible Causes of Trigeminal Neuralgia

The trigeminal nerve is responsible for the tactile sensations of the face, its sensitivity, the susceptibility of the oral cavity and affects the motor activity of the masticatory muscles. Neuralgia is the most common type of trigeminal nerve lesion.

This is a chronic disease characterized by acute paroxysmal pain in the zone of connection of the trigeminal nerve with the central nervous system. The disease is also called Fosergil's disease, or Trousseau's pain tic. The cranial nerves have many pairs of branches, the pathology is caused by the defeat of the fifth pair.

• congenital narrowness of the nerve canals along the entire length of the branches;
• pathology of vessels located near the innervation zone (aneurysms, atherosclerosis);
• ophthalmic diseases, diseases of the nasopharynx or oral cavity, which can cause the formation of a cyst or sticking of branches in the areas of branching of the trigeminal nerve;
• violations at work thyroid gland, metabolic problems;
• infectious chronic diseases such as syphilis, herpes, tuberculosis;
• any neoplasm in the nerve area;
• frostbite of the face;
• stem stroke and multiple sclerosis - in rare cases.

Facial neuritis can cause improper wisdom tooth extraction. The third molar has deep roots, so the extraction can easily hit the nerves. Also, the nerve can be damaged when installing a new denture. Depending on the cause of the pathology and the general condition of the body, not only the entire nerve branch is affected, but also its individual parts. Usually, neuralgia spreads on one side, but with untimely treatment, the disease can progress.

Varieties and symptoms of the disease

The trigeminal nerve has 3 branches, each of which is responsible for a specific part of the face:

• 1 - for the orbital area;
• 2 - for the cheek, nostril, upper lip and gum;
• 3 - for the lower jaw, lip and gum.

Types of neuralgia are classified based on the structure of the nerve. The most common neuralgia 2 branches. Also, experts make a conditional division into true and secondary neuralgia. In the first case, the pathology occurs as an independent disease resulting from nerve compression, in the second - as a complication of other diseases (often infectious).

Fosergil's disease is characteristic of older people, in 70% of cases the right side of the face is affected. According to the symptoms, pathology is divided into:

1. Reflex and movement disorders that manifest as muscle spasms that change the work of the muscles of the face, including chewing. Often one half of the face is affected entirely.
2. Trigeminal neuralgia, characterized by sharp severe pain(there may be up to 300 spasms per day lasting up to 3 seconds). Depending on the affected branch, the pain is localized in the region of the upper eyelid and above, the middle part of the face or the region of the lower jaw. A similar type can manifest itself in the form of atypical neuralgia, then between attacks the patient will feel aching pain.
3. Vegetative-trophic - characteristic symptoms in the initial stages, they are barely noticeable, but as the lesion progresses, they become apparent. During attacks, there is a change in skin color, a runny nose and increased salivation. Possible increase in body temperature. In advanced cases, eyelashes may fall out, the face swells, the work of the sebaceous glands changes.

If you do not start treatment of the disease on time, then a point of pain activity may form. This condition cannot be completely cured, the clinical picture is expressed by the following signs:

• pain is felt on the entire affected half of the face;
• sharp pain occurs even with a slight touch;
• irritation is caused by loud sounds, bright light;
• vegetative-trophic symptoms intensify and often appear;
• pain can become chronic.

Diagnostic methods

To diagnose neuralgia, the patient needs to describe in detail the nature of the pain and the place of its localization. The doctor will make the first conclusions, which can be confirmed by the results of reflex tests:

1. corneal (closing of the eyes in the presence of external stimuli);
2. superciliary (closing of the eyelids when the superciliary arch is tapped);
3. mandibular (contraction of masticatory and temporal muscles in response to tapping of the lower jaw).

Features of treatment

In the treatment of pain tic Trousseau leading role time plays - the earlier the disease is diagnosed, the faster and easier it is to get rid of its symptoms. Otherwise, neuralgia will go into chronic stage, and its final treatment will become impossible.

Therapy for trigeminal neuralgia includes several areas:

Medical therapy

To get rid of trigeminal neuralgia, several groups of tablets are used, among them antispasmodics, muscle relaxants and anticonvulsants. Most often, Finlepsin is used to relieve muscle cramps. It is based on carbamazepine, an antiepileptic substance used to treat various types of neuralgia.

Finlepsin stops pain attacks - the drug acts 8 hours after ingestion. In some cases, a positive result occurs on the 3rd day. The dosage is selected individually, but as it gets rid of pain, it decreases. Complete withdrawal of the drug occurs after 6 months without seizures. The disease can be treated with similar medicines based on carbamazepine.

1. Gabapentin is a neurontin-based anticonvulsant used to treat neuroleptic pain and epilepsy.
2. Baclosan is an anti-inflammatory and analgesic drug. It reduces muscle tone, inhibits the transmission of nerve impulses, at the same time relieves spasms and improves the motor activity of the joints, therefore it is often used in combination with massages and exercise therapy.
3. Prebagalin - anticonvulsant with analgesic and anxiolytic action. It can be used as an anesthetic, reduces the manifestations of a painful tick.

The doctor may prescribe only one medication or develop a regimen for the use of several drugs, determine the dosage. It is important not to take pills without consulting a therapist, as they have contraindications. For example, mandatory carbamazepine is prohibited during pregnancy and lactation. During pregnancy, treatment with ointments is prescribed local action and folk remedies.

Massage and physiotherapy treatment

Massage and physiotherapy are often used as part of complex treatment. Massage is necessary to eliminate muscle tone and improve blood microcirculation. The most important thing in such a massage is the effect on the reflex zones in the areas where the branches of the trigeminal nerve exit, that is, in the facial, ear and neck parts.

For effective massage the patient should sit down, lean his head back on the headrest, relax his neck. With light movements, the massage therapist acts on the sternocleidomastoid muscle, then, moving from the bottom up, approaches the parotid areas, goes to the muscles of the face. The timing of the onset of remission is individual. Recovery may take up to 14 sessions of 15 minutes. You can learn more about the technique of the procedure in the video.

Physiotherapy enhances the effect of drugs, can relieve pain, improve the condition of muscle tissue. For neuralgia use:

Physiotherapy in conjunction with painkillers is often prescribed in case of neuritis after tooth extraction. Such a lesion is treated faster, but only a doctor can determine how long it will take for a full recovery.

When is surgery indicated?

If none of the conservative methods of treatment has yielded results, or the pathology is caused by anomalies in the structure of blood vessels, nerve branches, then an operation is prescribed. In this case, treatment can be carried out according to the following methods:

1. In the early stages of the development of the disease, percutaneous surgery is used. The patient is given local anesthesia, a needle is inserted under the skin, through which the root is treated with current. The purpose of the operation is to kill the affected nerve.
2. Microvascular decompression is indicated when the cause of neuralgia is compression of the nerve by a vessel. The surgeon will separate the vessel from the nerve branch. After the operation, a positive result is observed, but there is a high probability of damage to the blood vessels.
3. Radiofrequency destruction involves the destruction of only one affected part of the nerve by exposure to high temperatures.
4. Glycerin injections - the substance is injected under the skin at the branching site of the root, its destruction occurs.

There is also a non-invasive method related to options surgical treatment. This is ionizing radiation that destroys the nerve root without mechanical action.

Folk remedies

Treatment at home should be agreed with the doctor. Traditional medicine methods should complement traditional means fight against pathology. Effective Recipes:

1. Chamomile decoction. The plant is famous for its soothing and anti-inflammatory properties. To prepare it, pour 1 tbsp. l. dried flowers 1 tbsp. boiling water, let the mixture brew and cool slightly, strain. If you have a toothache, put the decoction in your mouth and keep it on the affected side.
2. Fir oil will help soothe the pain - it is rubbed into the skin throughout the day. Reddening of the epidermis may be observed, but the pain will subside already on the 3rd day.
3. Buckwheat compress is a simple and effective method of relieving a pain symptom. Warm the cereal well in a pan, wrap it in a natural cloth and apply a compress to the affected area. It is worth keeping it until the cereal cools. Repeat the procedure three times a day.
4. People with normal skin that is not prone to irritation can use clay compresses. Dry powder is mixed with vinegar to a thick slurry, then formed thin pancake and apply it to the affected area.
5. Adults can use raspberry tincture. The leaves of the plant are poured with vodka in a ratio of 1: 3, then infused for 9 days. The finished product is consumed in small doses before meals for 3 months.
6. Freshly squeezed black radish juice should be wiped on the skin several times a day.
7. Date puree should be taken orally 3 tsp. in a day. The mass must be prepared daily, it is most convenient to use a blender.

Untreated pathology will not lead to death, but will significantly worsen the quality of life. Constant pain lead to stress and depression, nervousness. Also, pain interferes with eating normally, there is a decrease in body weight, immunity weakens. When the first symptoms of the disease appear, consult a doctor immediately.

trigeminal neuralgia

Neuralgia is a condition accompanied by acute paroxysmal pains in the area of ​​the nerve trunks. Neuralgias are characteristic not only of elderly patients: they are often observed in young people, especially in women. Among the requests for medical care a significant part of these pathologies account for the defeat of the facial nerve.

What is trigeminal neuralgia

The trigeminal nerve is one of the components of the innervation of the skull. Its main function is to provide facial sensitivity, so the branches are located on both sides and fit all the organs of the front of the head.

A disease in the form of a disorder of nerve function with short, but extremely severe attacks of pain, is called trigeminal neuralgia.

Pathology is more often chronic course: an acute condition is replaced by a long pain-free period.

The reasons

It is believed that the main etiological factor of the disease may be compression of the nerve by vessels with impaired physical form or abnormally overgrown, sclerotic plaques, less often - tumors in the cerebellum, neoplasms of the cranial nerves.

Other causes of neuralgia include:

• narrowing of the bone canal due to inflammation of the gums, maxillary sinuses, caries;
• congenital specific structure of the bones of the base of the skull;
• in persons with a weakened immune system, neuralgia can be caused by the herpes virus present in the body.

Often, the exact cause of the disease cannot be established. In this case, neuralgia is considered idiopathic.

To provoke repeated bouts of pain can:

• transferred stresses;
• hypothermia;
• wind impact;
• facial trauma;
• decline immune protection organism;
• long conversation;
• chewing solid food;
• shaving, brushing teeth.

The average cost of MRI of cerebral vessels can be found here. There you will also find information about how the procedure itself takes place and in what cases it is not done.

Symptoms of the disease

All symptoms of the disease are localized along the pathologically affected nerve trunk (jaw, forehead, eyebrows, cheek). Usually the most painful are the points of approach of the nerve branches to the epidermis (eye socket, chin).

Patients describe their sensations in different ways, but more often - in the form of unbearable, burning-jerking pain, lasting from a couple of seconds to several minutes. Unpleasant feelings in most cases arise in the nasolabial triangle, further spreading to wider areas.

A person with spontaneous neuralgia can suddenly freeze or begin to rub his face intensively. Sudden pain can also radiate to the ears, teeth, scalp, and also to the fingers.

A frequent occurrence is a painful tic due to spasm of the muscle in the area of ​​the affected nerve.

Other symptoms that can complement clinical picture neuralgia of the facial nerve:

• redness of the skin of the face (general or in the form of spots);
• burning after the cessation of intense pain;
• uncontrolled salivation, lacrimation;
• absence of pain at night, as well as their reduction with strong pressure on the skin.

In some people, the disease has single episodes throughout life, in others it proceeds in the form of remissions and exacerbations. The danger of neuralgia is that over time it can progress with increased pain and more frequent acute periods.

Unpredictable seizures also cause mental disorders: a person, in anticipation of pain, can lose self-control, stop eating well, neglect hygiene, quit work, and physical activity.

In especially severe cases, deep depression can even lead to suicide.

The photo shows the main localization of pain in trigeminal neuralgia:

Treatment

Medical

When choosing drugs for the treatment of a disease, its causes are taken into account, which are revealed during a thorough diagnosis and differential comparison with infectious, vascular and tumor pathologies of the head.

Most often, one or more drugs from the following groups are prescribed:

• Antiepileptic drugs (carbamazepine, oxcarbazepine, difenin, acediprol, tebantin). The most commonly used first-line treatment is carbamazepine, but due to side effects Mandatory monitoring of blood counts and regular assessment of liver function are required. The course of treatment can be long with a gradual decrease in dosage.
• In case of inefficiency, second-line drugs from the same pharmaceutical group (finlepsin, difenin, phenytoin) are used.

• Muscle relaxants central action(baclofen, baclosan, sirdalud) to eliminate muscle spasticity in neuralgia.
• Antidepressants are recommended for taking at bedtime (amitriptyline, trazodone).
• Vitamins of group B (intramuscularly). The drugs of choice are milgamma, neurorubin.
• Topically, you can use any creams and ointments with non-steroidal anti-inflammatory components (bystrum-gel, diclak, diclofenac) to relieve pain.
• To relieve pain in medical institution perform phonophoresis, electrophoresis with novocaine, lidocaine, UHF, acupuncture, microcurrent therapy. The patient can also be relieved by taking non-steroidal anti-inflammatory drugs, analgesics in tablets.
• Usually, after 1-3 months, in the absence of results from conservative therapy, surgery is planned (decompression of the nerve trunks using microsurgical methods).

Massage for trigeminal neuralgia

Before performing a massage on your own, you should consult with your doctor in order to avoid a new attack of pain with the wrong technique.

The main methods used:

• rubbing shoulders, neck, hands;
• stroking the back of the head, the bottom of the scalp before moving to the neck;
• light vibrating movements in the cheekbones, cheeks;
• massage with fingertips in the area of ​​​​the eyebrows, forehead, nasolabial triangle.

All movements are performed without strong pressure. It is allowed to use a vibration massager (with the permission of the attending physician). The duration of the session is minutes every day, the course is up to 25 procedures.

Gymnastics

Movements and contractions of the facial muscles cause not only relief during the next attack of the disease, but also help to reduce the compression of the nerve branches in the future. Additional positive effects of gymnastics:

• improvement of blood circulation;
• optimization of lymph outflow;
• restoration of the conductivity of nerve impulses (if it is disturbed);
• prevention of the development of stagnation in the muscles.

• Tilts and circular rotations of the head (2 minutes).
• Stretching the neck and head as far as possible towards each shoulder (4 times).
• Stretching the lips in a smile, bringing them into a "tube" (6 times).
• Drawing air into the cheeks, exhaling it through a narrow gap in the lips (4 times).
• Cheek retraction (6 times).
• Closing and opening of the eyes with strong contraction of the eyelids (6 times).
• Raising the eyebrows up while fixing the forehead with the hand (6 times).

Lumbodynia of vertebrogenic origin - all about the disease, the features of its course, diagnosis and treatment.

Dizziness can be caused by osteochondrosis of the cervical region. Read more in this article.

For VSD treatment often use Mexidol. The average price for 10 ampoules of this drug can be found at http://gidmed.com/lekarstva/meksidol-v-ampulah.html.

Folk methods

Funds alternative medicine it is unlikely to cure such a disease, but it is quite possible to relieve pain, relax muscles and “delay” a new attack. The following methods of therapy are considered the most useful and effective:

• Birch buds insist on vodka (3 tablespoons of buds per 0.25 liters of vodka) for 20 days. Then perform compresses on the affected area daily.
• Horseradish is rubbed and applied to the skin of the face for 5-10 minutes in the form of a lotion.
• Lilac buds are collected (50 g), boiled in 300 ml. water 15 minutes. Then melt 2 tablespoons of lard and combine with 1 tablespoon of broth. The ointment is used daily, and compresses are made from the decoction with an exposure time of 30 minutes.
• It will be useful to drink daily teas from mint leaves, fireweed, raspberry leaves, St. John's wort. These plants relieve inflammation, relax muscles, improve the body's resistance.

Prognosis for recovery and prevention of neuralgia

As a rule, exacerbations of pain occur in the spring and autumn periods.

Seeing a doctor early can help prevent recurrence, as more than 70% of trigeminal neuralgia episodes resolve completely with anticonvulsants and never return.

Particularly easy to drug therapy pathologies due to trauma, as well as diseases that have developed in young people. In old age, often only surgical intervention returns the patient to a full life.

To prevent neuralgia, the following measures should be observed:

• timely treat teeth, sinusitis, sinusitis;
• do not overcool;
• reduce the harmful effects of stress;
• increase immunity, harden;
• timely eliminate any acute infections.

Trigeminal neuralgia is a severely tolerated but treatable disease. Compliance with preventive measures and proper and timely treatment is the key to a return to a full life.

Neurosurgeon about trigeminal neuralgia:

Neuralgia of the facial nerve

Facial neuralgia, also known as neuritis or Fottergil's syndrome, is a pathological condition in which a person's facial expressions are disturbed, paralysis or weakening of the movement of the facial muscles is observed. With neuralgia, inflammation of the trigeminal nerve (one or more branches) occurs. Most often, neuralgia occurs in middle-aged and elderly patients. Treatment is long enough, the disease is difficult to treat.

ICD-10 code

Causes of neuralgia of the facial nerve

Facial neuralgia develops due to compression of the facial nerve root by the cerebellar artery at the point where it passes into the brainstem. The artery can compress the trigeminal nerve or wrap around, which destroys the sheath of the nerve fibers.

The cause of compression may be a decrease in the lumen of the bone canal through which the trigeminal nerve passes due to inflammation of the nasal mucosa, periodontal disease, and other inflammatory diseases.

In addition, the destruction of the neural membrane can begin due to drafts that supercool the nerve fibers and lead to spasms of the facial muscles responsible for facial expressions. A common cause of neuralgia is disruption of the endocrine system, the herpes virus, vascular and neurogenic disorders, pressure from a growing cyst or tumor.

Symptoms of neuralgia of the facial nerve

The disease is accompanied by pain, usually paroxysmal, as well as changes in the face (misalignment), but the sensitivity of the face is not disturbed.

Neuralgia of the facial nerve is accompanied by paroxysmal, severe pain. The interval between attacks can vary from several hours to several weeks.

Pain can occur in the area of ​​​​the mouth, teeth, ear, eyes. During an attack, a tick may appear. Opening the mouth, chewing, talking (especially long), shaving, swallowing, cold air can provoke an attack.

Also, with the disease, there is a contraction of facial muscles on one side of the face.

Where does it hurt?

Diagnosis of neuralgia of the facial nerve

Neuralgia of the facial nerve proceeds with bright pronounced signs, which practically does not cause difficulties in diagnosis and diagnosis.

With neuralgia, the patient complains of burning and sharp pains in the face, which usually appear suddenly. Attacks can last from 10 seconds to 2-3 minutes, then pass on their own.

Usually pains appear in that part of the face where the branches of the trigeminal nerve are inflamed, always occur only on one side, can give shooting or "electric" pain in the eye, ear, neck, etc. The most severe attacks are observed in patients with lesions of all three branches of the nerve .

During an attack, convulsive contractions of the muscles of the face appear, while the patient tries as much as possible to reduce facial expressions, often at this moment salivation increases, sweating appears, the skin on the face turns red.

Pain can occur both on its own and with certain movements, such as while shaving or talking.

In the intervals between attacks, a person is practically healthy, no signs of pathology can be detected.

Sometimes when pressing on certain points of the nerve, pain may appear.

Pain is usually localized in one place and due to pathology, patients long time chew food on the other side, which after a while leads to the appearance of muscle seals, muscle dystrophy, and decreased sensitivity.

At the appointment, the neurologist immediately notes how the patient talks about seizures, while trying not to touch the affected side of the face. As a rule, the patient is tense, is in constant expectation of a new attack.

What needs to be examined?

Who to contact?

Treatment of neuralgia of the facial nerve

Neuralgia of the facial nerve is quite difficult to treat. There are two methods of treatment of this pathology: conservative and surgical.

With conservative treatment, medications are usually prescribed in combination with physiotherapy procedures.

In case of neuralgia, the specialist prescribes anticonvulsants (pregabalin, carbamazepine, finlepsin, etc.), antispasmodic drugs, acupuncture, paraffin applications, Bernard currents.

Conservative treatment for a number of reasons may not have the desired effect, for example, if the dosage of the drugs is calculated incorrectly, or the patient takes the pills irregularly or misses the prescribed procedures.

In this case, the doctor may decide on surgical treatment.

The most effective method is microvascular root decompression, during which the specialist performs a trepanation and inserts special implants that help relieve pressure on the nerve root.

Also, with neuralgia, radiofrequency destruction can be used, with the help of which the root of the trigeminal nerve is destroyed.

Recently appeared new method surgical treatment - neurostimulation of the motor cortex of the brain. This method is minimally invasive (i.e. intervention in the body is minimized) and less risky, unlike macrovascular decompression, and the effectiveness of this technique has been proven by foreign researchers. As a rule, after several sessions, the pain practically disappears, with successful results, electrodes are implanted in the cerebral cortex.

There are also folk methods of neuralgia that will not completely get rid of the disease, but will help reduce painful symptoms.

A rather effective method is a fresh onion compress (put finely chopped onions in a wide bandage or gauze and apply to the sore spot).

A cold compress of boiled garlic and lemon juice also helps.

Often, neuralgia develops from a lack of calcium or magnesium, B vitamins in the body, so it is recommended to consume more foods that contain these elements (milk, eggs, cheeses, fish, meat, nuts, seeds).

Gymnastics for neuralgia of the facial nerve

Neuralgia of the facial nerve causes strong contractions of the muscles of the face, and gymnastics will not only alleviate the condition during the next attack, but also help reduce pressure on the nerve root.

Gymnastics improves blood flow, lymph outflow, restores disturbed conduction of impulses of nerve endings, and prevents muscle congestion.

It is best to perform the exercises in front of a mirror in order to control the process as much as possible.

The set of exercises should include:

• circular rotations and head tilts (two minutes each),
• tilt of the head towards the shoulder and maximum stretching of the neck (four times in each direction),
• bringing lips into a “tube” and stretching in a smile (six times),
• taking air into the mouth (while the cheeks should be as inflated as possible) and exhaling through a thin gap between the lips (four times),
• retraction of the cheeks (six times),
• opening and closing the eyes, while the eyelids should contract and open with force (six times),
• maximum raising of the eyebrows, while the forehead must be fixed by hand (six times).

The human face is capable of expressing the most subtle and deep shades of emotional experiences. This opportunity is the basis of communication, which is vital for every individual to adapt in modern society. Neuritis of the facial nerve - the so-called Bell's palsy, depriving part of the muscles of the face of mobility and ugly distorting facial expressions, becomes not only a medical, but also a social problem for the patient.

What causes Bell's palsy?

Inflammation of the facial nerve may be due to:

• infectious, viral or bacterial invasion;
• metabolic disorders, such as persistent hyperglycemia in diabetes;
• congenital narrowness of the bone canal that releases the facial nerve from the skull;
• traumatic narrowing of the canal in fractures of the body of the temporal bone;
• inflammatory processes in the ear;
• diffuse collagenosis;
• tumor processes;
• inflammation of the meninges;
• multiple sclerosis;
• edematous syndrome during pregnancy;
• acute NMC.

The start of the inflammatory process in the nerve trunk is given by general and local hypothermia. Very often, Bell's palsy is provoked by drafts.
In pediatric practice, neuritis of the facial nerves are as common as in adults. But the list of causes that cause them is much shorter. The starting factor for neuritis in a child is mainly otitis media, provoked by hypothermia or drafts.

How does Bell's palsy occur?

In the pathomechanism of the lesion, the most significant stages are conditionally distinguished:

• spasm of blood supplying arterioles;
• lack of blood supply to the nerve;
• hypoxia of nerve cells;
• swelling of the nerve trunk;
• the formation of microhemorrhages in it.

The resulting inflammatory process blocks or limits the transmission of nerve impulses from the brain to the receptors of the facial muscles. Imperative signals from the nuclei of the brain remain without a mimic response, which in a patient with neuritis is manifested by the inability to control the muscles of the affected half of the face. Wherein:

• the clinical picture of the initial attack and the acute process appear at lightning speed - within a day or faster;
• it may be accompanied by pain.

But this is not necessary, often the patient, quite unexpectedly for himself, suddenly sees a reflection of an asymmetric face in the mirror. He realizes that he cannot smile, frown or raise his eyebrows, finds difficulty in chewing food.

The main symptoms of neuritis

The visual picture of the immobilized half of the face, innervated by the inflamed nerve, resembles a mask. At the same time, it is striking that, compared with the healthy side:

• palpebral fissure is slightly wider;
• noticeably below the level of the corner of the mouth;
• there is a smoothness of the nasolabial fold;
• the severity of transverse frontal wrinkles is determined.

When trying to express emotions, the degree of asymmetry increases:

• An attempt to smile turns the mouth into a shape resembling a tennis racket.
• An attempt to close one's eyes demonstrates what a "hare's eye" symptom is, when the eyelid does not close completely, and the sclera turns white in the remaining gap.

While eating, you can observe that:

• attempting to take liquid food ends up running down the chin on the affected side;
• an attempt to chew a hard piece of food is accompanied by biting the cheek.

Neurologists are engaged in the final diagnosis of neuritis, when making a diagnosis, the following are taken into account:

• complaints and deviations of the neurological status;
• results of clinical studies of blood and urine;
• X-ray data;
• electromyography indicators;
• conclusions of computer (CT) and magnetic resonance (MRI) tomography.

Features of the course of the disease

Recovery of nervous tissue is extremely slow, respectively, clinical course neuritis is characterized by:

• duration and sustainability;
• resistance to ongoing therapy;
• prone to relapse.

The question of how much neuritis is treated is asked by the attending physician almost every patient. Recovery of nerve tissue may require months of treatment. The disease, receding for a short time under the influence of drug therapy, tends to return again and again, persistently showing a tendency to recur. It is considered a great success if it is possible to cure the patient in a month, more often a complete recovery does not occur even after six months of treatment. In pediatric practice, the prognosis is much more favorable, only 2-3 weeks separate from the complete recovery of an acutely ill child.

Tactics of therapeutic measures

Only the right approach to treatment and adherence to the right tactics can:

• provide the patient with a stable recovery;
• eliminate undesirable consequences;
• ensure a favorable prognosis.

The primary conditions for guaranteeing therapeutic success are:

• the start of drug therapy should be given immediately;
• treatment should be carried out in a hospital setting or in day hospitals polyclinic;
• therapeutic measures should be comprehensive.

It is impossible to achieve stable positive dynamics with neuritis at home. There is a risk that violations of the innervation of the facial muscles will become permanent, their contractures will occur. Therapeutic efforts for neuritis should be comprehensive, include several mandatory areas:

• medicinal effect;
• electro-physiotherapy procedures;
• massage courses;
• training of facial muscles;
• acupuncture sessions.

Medical treatment

The understanding of the pathomechanism of neuritis development has given clinicians the opportunity to determine how and with what to treat Bell's palsy in order to achieve the optimal result. The drug therapy regimen should include components that affect each of the stages of the inflammatory process:

• antispasmodics;
• decongestants;
• anti-inflammatory;
• neurotropic.

Depending on the suspected cause of the disease, antiviral or antibiotic therapy is prescribed. If necessary, pain medications are prescribed and vitamin complexes. Improving the conduction of nerve signals through the muscles is achieved by anticholinesterase agents, using modern effective drugs such as Neuromidin, Ipigrix or Amiridin. The appointment of a drug complex is the absolute prerogative of the doctor. The patient should not decide for himself how to treat such a therapy-resistant disease or replace the medicines recommended by the attending doctor with folk remedies.

Physiotherapeutic effect

The purpose of prescribing physiotherapy is to increase the effectiveness of treatment. Under their influence:

• stimulates local blood circulation;
• conduction along the nerve trunks of impulses increases;
• the effect on the nervous tissue of drugs is enhanced.

Types of physiotherapy, the sequence and duration of their courses are selected individually for each patient. Successful application in the treatment of neuritis found methods:

• magnetotherapy;
• diadynamic therapy;
• phono- and electrophoresis;
• carboxypunctures;
• laser therapy;
• darsonvalization;
• UHF and UFO.

Assigned on time (namely, from the 7th to 10th day of the treatment process), physiotherapy increases the effectiveness of drugs and reduces the possibility of developing unwanted complications.

Restrictions in the appointment of physiotherapy

The success and safety of the use of physiotherapy courses is ensured by the observance of reasonable caution. For example, during pregnancy, due to the possibility of a negative effect on the fetus, the use of:

• magnetotherapy;
• microwave therapy.

The appointment of physiotherapy for children with malnutrition, with reduced adaptive and reactive capabilities of the body, with the risk of dissemination of a concomitant disease, against the background of hyperthermia and a tendency to hemorrhages, is limited. There are also age restrictions for the use of physiotherapy in children. Allowed appointment:

• UHF, UV and microwave therapy - from birth;
• electrophoresis - from the second month of life;
• ultrasound and electrical stimulation - from two years;
• dynamic currents - only from the age of seven.

Restoration of facial expressions with massage and exercise therapy

Massage courses are prescribed no earlier than 3-4 weeks from the start of drug therapy, their duration is selected individually for each patient. On average, a full course can include from 10 to 15 sessions. Massage for neuritis should be carried out only by an experienced massage therapist, because:

• the impact zone is an extremely sensitive area - the face;
• the procedure will require the health worker special training and specific professional skills.

During a visit to a session with a specialist, the patient is recommended to remember the sequence and intensity of the manipulations, so that later, already at home, to be able to continue the course on their own to consolidate the effect. Perfectly combined, complementing each other, massage and gymnastics for the face. Interacting, they give an enhanced effect, allowing you to quickly restore facial expressions. It is recommended that patients continue to perform exercises that train the facial muscles even after discharge at home.

Application of surgical methods

In cases where complex therapy measures fail to achieve clinical improvement even in 8-10 months, the patient is transferred to surgeons. Most often, surgical intervention is resorted to:

• with compression of the facial nerve in the fallopian canal;
• in violation of its integrity of traumatic origin.

The facial nerve trunk and its branches after the operation are able to fully restore their functionality. The help of plastic surgeons is resorted to when muscle contractures appear on the face after neuritis. In this case operational method only the elimination of a cosmetic defect is subject to. Contracted muscles that have lost their elasticity due to prolonged inactivity are unable to regain their functionality.