How is facial neuritis best treated?

Written by Tang Bo
Neurology
Updated on September 13, 2024
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The treatment of facial neuritis primarily aims to improve local blood circulation, alleviate facial nerve edema, relieve nerve compression, and promote the recovery of nerve function. Therefore, its treatment includes medication, which mainly nourishes the nerves, and may also involve antiviral drugs and corticosteroids. Physiotherapy, particularly post-acute phase, can include acupuncture or infrared radiation and local heat application. Eye protection is also necessary because patients with facial neuritis may not be able to fully close their eyelids, leaving the cornea exposed and susceptible to infection. Finally, rehabilitation treatment includes acupuncture, which is also part of the mentioned physiotherapy.

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Written by Zhang Hui
Neurology
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Symptoms of facial neuritis

Facial neuritis, known as idiopathic facial paralysis, is a common disease in neurology. The main clinical manifestations and symptoms include acute onset, peaking within several hours to days. The primary manifestation is paralysis of the expression muscles on the affected side of the face, such as diminished forehead wrinkles, inability to open the eye, furrow the brow, or weak eyelid closure. Some patients may experience pain behind the ear, and in the tympanic membrane and external ear canal. Additionally, some patients exhibit deviation of the mouth corner, air leakage when puffing or whistling, and difficulty retaining food residues while eating or leaking water while drinking. Other patients may experience loss of taste in the anterior two-thirds of the tongue, along with secretion disorders of the salivary and lacrimal glands. Overall, the diagnosis of facial neuritis is relatively straightforward, and its clinical presentation is not particularly complex. Once the diagnosis is confirmed, timely treatment is essential, and most patients can recover.

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Written by Yuan Jun Li
Neurology
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How to determine if facial neuritis is cured?

Patients with facial neuritis, if the paralysis of the facial expression muscles returns to normal, are generally considered cured. After the onset of the disease, patients must receive early and timely treatment. Corticosteroids such as dexamethasone, prednisone, and methylprednisolone can be used, along with B vitamins to nourish the nerves. Commonly used are vitamin B1, vitamin B12, adenosylcobalamin, and methylcobalamin, among others. One week after the onset, acupuncture treatment can be considered, as well as massage, physical therapy, and heat therapy. Most patients begin to recover two weeks after treatment, and basically return to normal within two months, with a minority possibly experiencing certain sequelae, such as facial muscle spasms or remaining facial muscle paralysis. (The use of medications should be under the guidance of a physician.)

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Written by Liu Shi Xiang
Neurology
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The difference between facial neuritis and facial nerve paralysis

The difference between facial neuritis and facial nerve paralysis is that facial neuritis refers specifically to peripheral facial paralysis, while facial nerve paralysis is a broader concept. It includes peripheral facial palsy caused by facial neuritis, as well as central facial palsy caused by cerebrovascular diseases. Therefore, the two have different clinical concepts and symptoms. Facial neuritis can involve paralysis of the entire facial muscles, including the disappearance of forehead lines and the shallowing of the nasolabial fold below the eye slit, as well as deviation of the mouth corner. Facial nerve paralysis, in addition to the symptoms caused by facial neuritis, may also include central facial palsy caused by cerebrovascular diseases. Central facial palsy does not affect the facial muscles above the eye slit, but only causes paralysis of the facial muscles below the eye slit, including shallowing of the nasolabial fold and deviation of the mouth corner. Therefore, facial nerve paralysis is a more extensive concept.

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Written by Zhang Hui
Neurology
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What causes facial neuritis?

Facial neuritis is very common in neurology, mainly caused by nonspecific inflammatory responses. For example, some patients with facial neuritis may experience viral infections, leading to inflammatory reactions in the muscles. Some patients develop inflammation of the facial nerve due to exposure to cold winds. Others may have immune dysfunction or rheumatic autoimmune diseases, which lead to inflammation of the facial nerve. Patients with facial neuritis usually experience paralysis of the facial muscles and may also experience significant pain, especially in the mastoid and external auditory canal. It is essential to treat facial neuritis early, using corticosteroids and B vitamins, as many patients have a good prognosis after treatment.

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Does facial neuritis need treatment?

Bell's palsy is a nonspecific inflammatory reaction, primarily caused by impairment of the facial nerve leading to paralysis of the facial muscles. In general, if the symptoms of Bell's palsy are mild, such as slight drooping of the corner of the mouth and drooling, there is a possibility for spontaneous recovery. However, if the symptoms of Bell's palsy are severe, and the patient also has risk factors for diabetes, these symptoms mainly include noticeably shallower forehead wrinkles, weakness in opening and closing the eyes, inability to close the eyes while sleeping, and very severe facial paralysis. In such cases, spontaneous recovery is difficult, and active treatment is required. Treatment mainly includes corticosteroid drugs and B vitamins, along with some rehabilitative training. In summary, Bell's palsy can resolve on its own if the symptoms are mild; however, if the symptoms are severe, timely treatment is necessary to avoid lasting effects.