In recent years, facial paralysis has attracted more and more attention. Facial paralysis not only affects the patient's facial expression and speech function, but also may have a serious impact on the patient's social and mental health. Therefore, in this episode, we will delve into the causes and symptoms of facial paralysis and how to recognize it early.
Online big doctor: Lin Chang
The First Affiliated Hospital of Fujian Medical University
Chief of the Department of Otolaryngology-Head and Neck Surgery
Professor, Chief Physician, Doctor of Medicine, Doctoral Supervisor
Topic of this issue: Don't be careless about facial paralysis, it is very important to standardize diagnosis and treatment
What is facial paralysis
Facial paralysis, medically known as facial nerve palsy or facial nerve paralysis, is a common condition that can occur in a variety of genders and age groups. Its symptoms are mainly manifested as motor dysfunction of facial muscle groups, such as crooked mouth, slanted eyes, drooling, language dysfunction, eating dysfunction, etc.
Types of facial paralysis
Central facial palsy: usually caused by cerebrovascular disease, intracranial tumor, etc., mainly affecting cortical brainstem fibers and supracortical tissues above the facial nerve nucleus. It is characterized by no impact on frontal lines, bilateral frontal lines, strong eyelid closure, but lower eyelid involvement, shallow nasolabial folds, and tongue coating may be present in patients with facial paralysis, i.e., tongue protrusion that deviates to the ipsilateral side.
Peripheral facial paralysis: more commonly facial neuritis, which can be caused by exposure to cold, viral infections, etc. It is manifested as paralysis of all facial muscles on the same side of the lesion, such as inability to frown, frown, and close eyes, and symptoms such as dysgeusia and unclear speech may occur.
Causes of peripheral facial paralysis
Infection: Infections are one of the common causes of peripheral facial paralysis and include viral infections such as shingles, herpes simplex, mumps, and bacterial infections. These infections can lead to facial neuritis, which can cause facial paralysis.
Cerebrovascular disease: Stroke located in and around the brainstem facial nerve, which can cause unilateral or bilateral peripheral facial palsy.
Trauma: Traumatic brain injury, such as basilar skull fracture, facial trauma, or surgery, can directly or indirectly cause facial nerve injury, resulting in peripheral facial paralysis.
Tumors: Peripheral facial paralysis can occur by direct compression of the facial nerve or by stretching the facial nerve during surgery.
Abnormal immunity: Studies have shown that abnormal immunity is an intrinsic leading factor in the occurrence of facial neuritis, which may lead to damage to the facial nerve, which in turn can lead to facial paralysis.
Other factors, such as cold, metabolic diseases (e.g., diabetes), and autonomic instability, may also cause peripheral facial palsy. These factors may lead to local neurotrophic vasospasm, resulting in ischemic edema of the facial nerve, and because the facial nerve canal is a bony lacuna with limited volume, facial nerve edema may lead to compression of the facial nerve, and then axonal degeneration, causing facial paralysis.
How to recognize facial paralysis
Observe facial expressions: Patients with facial paralysis are often unable to perform some basic facial expressions, such as raising eyebrows, closing eyes, and puffing out their mouths. Closer examination of the patient's face reveals that facial muscles are relaxed, forehead wrinkles disappear, eye fissures may widen, nasolabial folds become flattened, and the corners of the mouth may droop and tilt to one side.
Check the eyelid reflex: in people with facial paralysis, the upper eyelid may droop and the lower eyelid tension disappears, resulting in the eye not closing completely. When trying to close the eye, eyelid tremor, which is a subtle muscle contracture flutter in one upper eyelid, may occur.
Assessment of masticatory function: facial paralysis may affect chewing and swallowing function, and patients may develop symptoms such as slurred speech and difficulty swallowing.
Pay attention to the initial symptoms: In the early stage of facial paralysis, patients may have asymmetry of blink movements and positive eyelash signs.
Other symptoms: Patients may experience facial stiffness, tearing, etc. In severe cases, dysgeusia, slurred speech, etc., may also occur.
If these symptoms are observed, suspicion of facial paralysis should be high. To ensure an accurate diagnosis, it is advisable to seek medical attention as soon as possible for further examination by a medical professional. Diagnosis of facial palsy is usually confirmed by a combination of history, physical examination, neuroelectrophysiologic examination, and imaging tests (eg, CT or MRI).
Disclaimer
This article aims to popularize health science, to help you understand diseases and medications, the content of popular science can not replace the doctor's diagnosis and treatment opinions, for reference only, if you have related health problems, please consult a doctor in time.
Introduced by the doctor
Lin Chang
Doctor of Medicine, Professor, Chief Physician, Doctoral Supervisor. He is currently the director of the Department of Otolaryngology of the First Affiliated Hospital of Fujian Medical University, the chairman of the Otolaryngology Head and Neck Surgery Branch of Fujian Medical Association, the director of the Fujian Institute of Otolaryngology, the member of the Otolaryngology Head and Neck Surgeon Branch of the Chinese Medical Doctor Association, and the director of the Joint Teaching and Research Department of Otolaryngology-Head and Neck Surgery of Fujian Medical University. He is a member of the editorial board of 6 professional journals including the Chinese Journal of Otolaryngology-Head and Neck Surgery. He has presided over 10 scientific research projects of various types of sub-projects of the National Science and Technology Key R&D Program, and published more than 70 academic papers. He has won one second and third prize of Fujian Provincial Science and Technology Progress Award, one third prize of Chinese Medical Science and Technology Award, and one third prize of Fujian Medical Science Award. Participated in the compilation and editor-in-chief of 5 planning textbooks for medical colleges and universities.