Facial nerve problems and Bell's palsy facts
What is the facial nerve?
The facial nerve is a nerve that controls the muscles on the side of the face. It allows us to show expression, smile, cry, and wink. Injury to the facial nerve can cause a socially and psychologically devastating physical defect; although most cases resolve spontaneously, treatment may ultimately require extensive rehabilitation or multiple procedures.
The facial nerve is the seventh of the twelve cranial nerves. Everyone has two facial nerves, one for each side of the face. The facial nerve travels with the hearing nerve (the eighth cranial nerve) as it travels in and around the structures of the middle ear. It exits the front of the ear at the stylomastoid foramen (a hole in the skull base), where it then travels through the parotid gland. In the parotid gland it divides into many branches that provide motor function for the various muscles and glands of the head and neck.
What are symptoms of a facial nerve problem?
Facial nerve problems may result in facial muscle paralysis, weakness, or twitching of the face. Dryness of the eye or the mouth, alteration of taste on the affected side, or even excessive tearing or salivation can be seen as well. However, the finding of one of these symptoms does not necessarily imply a specific facial nerve problem; the physician needs to make a careful investigation in order to make a precise diagnosis. Symptoms of a facial nerve problem can vary in severity depending upon the extent of the injury to the nerve. Symptoms may range from mild twitching to full paralysis of the muscles on one side of the face.
What conditions affect the facial nerve?
There are numerous causes of facial nerve disorder:
How are the causes of facial nerve dysfunction diagnosed?
Causes of facial nerve disorder vary from unknown to life threatening. Sometimes, there is a specific treatment for the problem. Accordingly, it is important to investigate why the problem has occurred. The specific tests used for diagnosis will vary from patient to patient, but include:
What is and what causes Bell's palsy?
Bell's palsy (Bell palsy) is paralysis of the facial nerve of unknown cause. The diagnosis is made when no other cause can be identified. Although Bell's palsy is thought to be caused by a viral infection of the facial nerve, this hasn't been proven. Other names for this condition are "idiopathic facial palsy" or Antoni's palsy.
Bell's palsy is usually a self-limiting, non-life-threatening condition that resolves spontaneously, usually within six weeks. There is no predominant age or racial predilection; however, it is more common during pregnancy and slightly more common in menstruating females. In general, the incidence increases with advancing age. Children under the age of 13 seem less at risk of developing Bell's palsy than older individuals.
What are the symptoms of Bell's palsy?
The typical symptoms of Bell's palsy include:
What is the mechanism of injury in Bell's palsy?
While the actual mechanism of injury of the facial nerve in Bell's palsy is unknown, one proposed mechanism of injury includes:
What are treatment options of facial nerve paralysis?
There are no medications specifically approved to treat Bell's palsy. Underlying medical conditions that lead to facial nerve disorder are treated specifically according to the specific condition that is responsible for the damage to the nerve. Steroid medications (corticosteroids) are the best treatment for Bell's palsy, and it is recommended that all patients be treated. The usual amount is one milligram per kilogram body weight of prednisone (or steroid alternative) per day for 7 to 14 days. Recently, antiviral medications like acyclovir (Zovirax) given in conjunction with steroids have been demonstrated to increase recovery. Doses of the antiviral agent will vary with the drug chosen.
Although physical therapy and electrotherapy probably have no significant benefit, facial exercises can help prevent contractures of affected muscles. Surgical facial nerve decompression is controversial in Bell's palsy. Some physicians recommend surgical decompression during the first two weeks in patients showing the most severe nerve degeneration; however, there can be a substantial risk of hearing loss with this surgery.
What is the treatment for eye problems from facial nerve disorder?
Patients with facial nerve paralysis have difficulty keeping their eye closed because the muscles which close the eye cannot work. Serious complications can occur if the cornea of the eye becomes too dry. Treatment consists of:
What surgical reconstruction options are available?
Reconstructive options for patients with facial muscle weakness or paralysis include one or more of the following:
What is the prognosis for facial nerve problems?
The prognosis for facial nerve damage depends on the underlying cause. Many patients who have required surgery to remove tumors may have unavoidable permanent injury to the facial nerve, whereas a majority of persons who experience Bell's palsy will have complete recovery. The best outcomes occur with rapid diagnosis and treatment.
How are the causes of facial nerve dysfunction diagnosed?
Causes of facial nerve disorder vary from unknown to life threatening. Sometimes, there is a specific treatment for the problem. Accordingly, it is important to investigate why the problem has occurred. The specific tests used for diagnosis will vary from patient to patient, but include:
What is and what causes Bell's palsy?
Bell's palsy (Bell palsy) is paralysis of the facial nerve of unknown cause. The diagnosis is made when no other cause can be identified. Although Bell's palsy is thought to be caused by a viral infection of the facial nerve, this hasn't been proven. Other names for this condition are "idiopathic facial palsy" or Antoni's palsy.
Bell's palsy is usually a self-limiting, non-life-threatening condition that resolves spontaneously, usually within six weeks. There is no predominant age or racial predilection; however, it is more common during pregnancy and slightly more common in menstruating females. In general, the incidence increases with advancing age. Children under the age of 13 seem less at risk of developing Bell's palsy than older individuals.
What are the symptoms of Bell's palsy?
The typical symptoms of Bell's palsy include:
What is the mechanism of injury in Bell's palsy?
While the actual mechanism of injury of the facial nerve in Bell's palsy is unknown, one proposed mechanism of injury includes:
What are treatment options of facial nerve paralysis?
There are no medications specifically approved to treat Bell's palsy. Underlying medical conditions that lead to facial nerve disorder are treated specifically according to the specific condition that is responsible for the damage to the nerve. Steroid medications (corticosteroids) are the best treatment for Bell's palsy, and it is recommended that all patients be treated. The usual amount is one milligram per kilogram body weight of prednisone (or steroid alternative) per day for 7 to 14 days. Recently, antiviral medications like acyclovir (Zovirax) given in conjunction with steroids have been demonstrated to increase recovery. Doses of the antiviral agent will vary with the drug chosen.
Although physical therapy and electrotherapy probably have no significant benefit, facial exercises can help prevent contractures of affected muscles. Surgical facial nerve decompression is controversial in Bell's palsy. Some physicians recommend surgical decompression during the first two weeks in patients showing the most severe nerve degeneration; however, there can be a substantial risk of hearing loss with this surgery.
What is the treatment for eye problems from facial nerve disorder?
Patients with facial nerve paralysis have difficulty keeping their eye closed because the muscles which close the eye cannot work. Serious complications can occur if the cornea of the eye becomes too dry. Treatment consists of:
What surgical reconstruction options are available?
Reconstructive options for patients with facial muscle weakness or paralysis include one or more of the following:
What is the prognosis for facial nerve problems?
The prognosis for facial nerve damage depends on the underlying cause. Many patients who have required surgery to remove tumors may have unavoidable permanent injury to the facial nerve, whereas a majority of persons who experience Bell's palsy will have complete recovery. The best outcomes occur with rapid diagnosis and treatment.
Source: http://www.rxlist.com
Source: http://www.rxlist.com
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