Facial nerve paralysis

Introduction Face-to-face, scientific name facial nerve paralysis, also known as facial neuritis, Bell's palsy, Hunter syndrome, commonly known as "squeaky mouth", "squeaky mouth", "hanging wind", "hanging wind", "squeaky wind", etc. It is a common disease characterized by motor dysfunction of facial expression muscles. The general symptom is oblique eye and mouth. It is a common and frequently-occurring disease that is not limited by age and gender. The patient's face often fails to complete the basic eyebrow lifting, eye closing, drumsticks, and mouth.

Cause

1, more infectious lesions. It is caused by the activation of herpes zoster that is dormant in the sensory ganglia of the facial nerve.

2, psychological factors are one of the important factors that cause facial paralysis. Before the occurrence of facial nerve palsy, a considerable number of patients have physical fatigue, lack of sleep, mental stress and physical discomfort.

3, due to trauma, surgery, facial neuritis, space-occupying disease induced.

4, otogenic diseases, tumors, poisoning, metabolic disorders, vascular insufficiency and congenital facial nucleus hypoplasia.

an examination

Related inspection

Cerebrospinal fluid-bound myelin basic protein otolaryngography CT examination of facial nerve movement mandibular reflex examination

The clinical manifestations of facial paralysis are very special: most patients often find that one side of the cheeks is not working properly and the mouth is skewed when washing their face in the morning and gargle. In the side of the disease, the facial muscles are completely paralyzed, the forehead wrinkles disappear, the eye cracks expand, the nasolabial folds are flat, the mouth angles droop, and the mouth angles are hemiplegic to the healthy side when the teeth are exposed. The disease side can not do wrinkles, eyebrows, eyes closed, air and pouting. When the drumsticks and whistle are whistling, the affected side lips cannot be closed and leak. When eating, food residue often stays in the buccal space of the diseased side, and often has saliva from the side. As the punctum varus with the chin, the tears can not overflow as normal drainage.

Differential diagnosis

Face - diagnosis

Diagnosis is not difficult depending on the onset and clinical characteristics. The disease should be differentiated from facial facial paralysis, facial nerve palsy caused by acute infectious polyradiculitis, and posterior fossa inflammation and facial nerve paralysis caused by tumor.

Blink movement

Careful observation of the patient's blinking situation shows that the bilateral blinking motion is asymmetrical, which is of great significance. If the patient does a blink movement, the side of the paralysis is mild, and the blinking movement is slow and incomplete.

Eyelash sign

The paralyzed patient has strong closed eyes. When the normal person closes the eye strongly, the eyelashes are buried in the upper and lower eyelids. When the facial nerve is paralyzed, the eyelashes are exposed, especially in the case of mild paralysis, and the eyes are asymmetrical, and the asymmetry of the eyelashes is not obvious, but after a short time, the eyelashes on the mild paralysis side are slowly revealed. It is called lash mark positive.

Eyelid tremor

The eyes were closed strongly, and the examiner pressed the closed upper jaw with a force plate. At this time, there was a slight muscle contraction on one side, but not on the other side. This phenomenon exists, indicating mild facial nerve paralysis, peripheral facial paralysis is more common.

Oblique egg sign

When the patient has a large mouth and mild facial nerve paralysis, the affected side of the mouth is drooping and the oblique egg-shaped mouth. The difference from the oblique egg-shaped mouth of the trigeminal nerve branch is that there is no mandibular deviation. This is not obvious when central facial paralysis is paralyzed.

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