Facial neuralgia

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

Causes facial neuralgia

Facial neuralgia occurs when the cerebellar artery compresses the root of the facial nerve where it passes into the brainstem. The artery may compress the trigeminal nerve or wrap around it, which destroys the sheath of the nerve fibers.

The compression may be caused by 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 nerve sheath can begin due to drafts that overcool the nerve fibers and lead to spasms of the facial muscles responsible for facial expressions. A common cause of neuralgia is a disorder in the endocrine system, the herpes virus, vascular and neurogenic disorders, pressure from a growing cyst or tumor.

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Symptoms facial neuralgia

The disease is accompanied by pain, usually paroxysmal, as well as changes in the face (distortion), but facial sensitivity is not impaired.

Facial neuralgia is accompanied by paroxysmal, severe pain. The interval between attacks can vary from several hours to several weeks.

Pain may occur in the area of the mouth, teeth, ear, eyes. During an attack, a tic may appear. An attack can be provoked by opening the mouth, chewing, talking (especially long), shaving, swallowing, cold air.

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

Diagnostics facial neuralgia

Neuralgia of the facial nerve occurs with clearly expressed symptoms, which practically does not cause difficulties in diagnostics and diagnosis.

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

Usually, pain appears in the part of the face where the branches of the trigeminal nerve are inflamed, always occurs only on one side, and can radiate as shooting or “electrical” pain to 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 facial muscles appear, while the patient tries to reduce facial expressions as much as possible; often at this moment, salivation increases, sweating appears, and the skin on the face turns red.

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

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

Sometimes, pressure on certain nerve points may cause pain.

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

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

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Treatment facial neuralgia

Facial nerve neuralgia is quite difficult to treat. There are two methods of treating this pathology: conservative and surgical.

Conservative treatment usually involves the use of medications in combination with physical therapy.

For neuralgia, a specialist prescribes anticonvulsants (pregabalin, carbamazepine, finlepsin, etc.), antispasmodic drugs, acupuncture, paraffin applications, and Bernard currents.

Conservative treatment may not have the desired effect for a number of reasons, 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 to perform surgical treatment.

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

Also, for neuralgia, radiofrequency destruction can be used, with the help of which the root 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 (i.e. intervention in the body is minimized) and less risky, unlike macrovascular decompression, and the effectiveness of this method 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 for neuralgia that will not completely eliminate the disease, but will help reduce painful symptoms.

A compress made from fresh onions is considered to be quite an effective method (place 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 well.

In case of neuralgia, it is recommended to add more vitamins and nutrients to your diet; instead of tea, it is better to drink herbal infusions, such as 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, vitamins of group B, so it is recommended to consume more foods that contain these elements (milk, eggs, cheeses, fish, meat, nuts, seeds).

Gymnastics for facial nerve neuralgia

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

Gymnastics improves blood flow, lymph drainage, restores impaired conductivity of nerve impulses, and prevents muscle congestion.

It is best to do the exercises in front of a mirror to have maximum control over the process.

The set of exercises should include:

• circular rotations and head tilts (two minutes each),
• tilting the head towards the shoulder and maximally stretching the neck (four times in each direction),
• pursing the lips and stretching them into a smile (six times),
• taking air into the mouth (while the cheeks should be maximally puffed out) and exhaling through a thin gap between the lips (four times),
• sucking in cheeks (six times),
• opening and closing the eyes, while the eyelids should be squeezed and opened with force (six times),
• maximum eyebrow lift, while the forehead must be fixed with the hand (six times).

Prevention

Facial nerve neuralgia cannot be treated with preventive measures, since the causes of the disease (dilation of arteries, narrowing of the lumen of bone canals) cannot be prevented.

Since neuralgia is often caused by inflammatory processes in the oral cavity, nasal mucosa, etc., it is recommended to avoid hypothermia, drafts, wear hats in the cold season, and include in your diet foods enriched with calcium, magnesium, and B vitamins as a preventive measure against the disease.

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Forecast

Facial neuralgia, as already noted, is difficult to treat. Specialists cannot say exactly how a particular patient will respond to a particular treatment method, but in most cases at least one of them is effective and helps to get rid of the disease.

Most patients report significant improvements after pain-relieving injections and decompression treatment. The specialist is almost always able to relieve pain for a long time. Positive results of treatment with alternative medicine methods (acupuncture, meditation, manual therapy) are also noted.

This disease is a serious disorder that often leads to the development of depression. If treatment is untimely or ineffective, the patient's condition may significantly worsen, the person experiences severe discomfort due to their disease, due to constant expectations of an attack, the person may stop observing the rules of personal hygiene, quit their job, not visit public places, avoid communication with loved ones, etc. In some cases, against the background of severe depression and severe pain that occurs during an attack of neuralgia, a person may commit suicide.

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