Neuralgia of the facial nerve

Neuralgia of the facial nerve, also known as neuritis or Fottergil syndrome, is a pathological condition in which human mimicry is disrupted, paralysis or weakening of the facial musculature is observed. With neuralgia, there is inflammation of the trigeminal nerve (one or several branches). Most often, neuralgia is observed in patients of middle and advanced age. The treatment is quite long, the disease is difficult to treat.

Causes of the neuralgia of the facial nerve

Neuralgia of the facial nerve develops due to compression of the cerebellar artery of the root of the facial nerve in the place where it passes into the brain stem. The artery can clamp the trigeminal nerve or wrap around, which destroys the envelope of nerve fibers.

The cause of compression may be a decrease in the lumen of the bone channel, along which the trigeminal nerve is due to inflammation of the nasal mucosa, periodontal and other inflammatory diseases.

In addition, the destruction of the nerve shell can begin because of drafts that supercool the nerve fibers and cause spasms in the muscles of the person responsible for the facial expression. A frequent cause of neuralgia are disorders in the endocrine system, the herpes virus, vascular and neurogenic disorders, pressure from a growing cyst or tumor.

[1], [2]

Symptoms of the neuralgia of the facial nerve

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

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

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

Also, with the disease, there is a reduction in mimic muscles on one side of the face.

Diagnostics of the neuralgia of the facial nerve

Neuralgia of the facial nerve proceeds with 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 occur suddenly. Seizures can last from 10 seconds to 2-3 minutes, then go by yourself.

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

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

Pain can occur either independently or with certain movements, for example during shaving or talking.

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

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

The pain is usually localized in one place and because of pathology, patients chew food on the other side for a long time, which in time leads to the appearance of muscle tightness, muscle dystrophy, and a decrease in sensitivity.

At the appointment, the neurologist immediately notes how the patient tells about the attacks, 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.

[3], [4], [5], [6], [7], [8]

Treatment of the neuralgia of the facial nerve

Neuralgia of the facial nerve is treatable rather hard. There are two methods of treating this pathology: conservative and surgical.

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

With neuralgia, a specialist prescribes anticonvulsants (pregabalin, carbamazepine, finlepsin, etc.), spasmolytic drugs, acupuncture, paraffin applications, Bernard currents.

Conservative treatment for several reasons may not have the proper effect, for example, if the dosage of the drugs is not calculated correctly, or the patient took the pill irregularly or missed the prescribed procedures.

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

The most effective method is microvascular decompression of the spine, during which the expert spends trepanation and inserts special implants that help to remove pressure on the nerve root.

Also, with neuralgia, radiofrequency destruction can be used, by means of which the spine of the trigeminal nerve is destroyed.

Recently, a new method of surgical treatment has appeared - neurostimulation of the motor cortex of the brain. This method is minimally invasive (ie, the 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 alternative methods of neuralgia that will not relieve the disease completely, but will help reduce painful symptoms.

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

A cold compress made from boiled garlic and lemon juice also helps.

With neuralgia it is recommended to add to your diet more vitamins and nutrients, instead of tea it is better to drink broths of herbs, for example, chamomile or mint, instead of sugar it is better to use honey.

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

Gymnastics with neuralgia of the facial nerve

Neuralgia of the facial nerve causes severe contraction of the facial musculature, and gymnastics will not only ease the condition during the next attack, but also help reduce pressure on the nerve root.

Gymnastics improves blood flow, lymph drainage, restores impaired conduction of impulses of nerve endings, prevents stagnation in muscles.

Perform the exercises best in front of the mirror to maximize control of the process.

The set of exercises should include:

• circular rotations and head inclinations (two minutes each),
• the inclination of the head towards the shoulder and the maximum extension of the neck (four times in each direction),
• bringing the lips into a "tube" and stretching in a smile (six times),
• intake of air in the mouth (with the cheeks should be maximally inflated) and exhaling through a thin gap between the lips (four times),
• retraction of the cheeks (six times),
• the opening and closing of the eyes, while the eyelids should be compressed and opened with force (six times),
• the maximum raising of the eyebrows, while the forehead needs to be fixed by hand (six times).

Prevention

Neuralgia of the facial nerve can not be prevented, because the causes of the disease (expansion of the arteries, a decrease in the lumen of the bone channels) can not be prevented.

Since often the cause of neuralgia are inflammatory processes in the oral cavity, nasal mucosa, etc., it is recommended to avoid overcooling, drafts, wearing headdresses in the cold season, to include in your diet products enriched with calcium, magnesium, vitamins group B.

[9], [10], [11], [12], [13], [14], [15], [16], [17]

Forecast

Neuralgia of the facial nerve, as already noted, is difficult to treat. Specialists can not say exactly how a particular patient will react to a particular treatment method, however, in most cases at least one of them is effective and helps to get rid of the disease.

Most patients note significant improvements after analgesic injections, decompression treatment. Practically always the expert manages to stop painful sensations for a long time. Also positive results of treatment by methods of alternative medicine are noted (acupuncture, meditation, manual therapy).

This disease is a serious disorder, which often leads to the development of depression. If untimely or ineffective treatment, the patient's condition may deteriorate significantly, a person experiences severe discomfort due to his illness, because of constant expectations of an attack a person can stop observing personal hygiene rules, quit work, do not visit public places, avoid contact with relatives and .P. In some cases, against a background of severe depression and severe pain that occurs during an attack of neuralgia, a person can commit suicide.

[18], [19]