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Facial palsy, also known as peripheral facial palsy or Bell's facial palsy, is a neurological disorder that occurs when the facial nerve is affected for some reason, leading to symptoms such as crooked mouth, difficulty moving the face, lack of expression in one part of the face or just a tingling sensation.
Most of the time, facial paralysis is temporary, arising from an inflammation around the facial nerve that can appear after a virus infection, as in the case of herpes simplex, herpes zoster, cytomegalovirus (CMV), Epstein-Barr (EBV), rubella, mumps, or immune diseases such as Lyme disease.
If symptoms of facial paralysis are observed, it is important to consult a general practitioner to identify if there is a problem that needs treatment.In addition, if you experience other symptoms such as disorientation, weakness in other parts of the body, fever or fainting, it is important to go to the doctor immediately, as it can be a sign of more serious problems, such as a stroke.
The most common symptoms of facial paralysis include:
- Twisted mouth, which is more evident when trying to smile;
- Dry mouth;
- Lack of expression on one side of the face;
- Inability to fully close one eye, raise one eyebrow, or frown;
- Pain or tingling in head or jaw;
- Increased sensitivity of sound in one ear.
The diagnosis of facial paralysis is made through observation of the physician and, in most cases, it is not necessary to perform additional tests.However, to make sure that it is only a peripheral facial palsy, magnetic resonance imaging, electroneuromyography and blood tests, for example, can be used to find the exact diagnosis.
Causes of facial paralysis
Facial paralysis occurs due to the impairment of the facial nerves that leaves the facial muscles paralyzed. Some of the possible causes of paralysis are:
- Sudden change in temperature;
- Viral infection with herpes simplex, herpes zoster, Cytomegalovirus or others;
- Rarely, it can be a consequence of other diseases.
Thus, paralysis can occur in the path of the facial nerve while still inside the brain or outside it. When it occurs inside the brain, it is a consequence of the stroke and is accompanied by other symptoms and sequelae.When it occurs outside the brain, in the path of the face, it is easier to treat and, in this case, it is called peripheral facial palsy or Bell's palsy.
How the treatment is done
Generally, the treatment for facial paralysis consists of the administration of corticosteroid drugs, such as prednisone, to which an antiviral drug, such as valaciclovir, can be associated, however, the doctor only recommends it in some cases.
In addition, it is also necessary to do physical therapy and apply lubricating eye drops to prevent eye dryness. The use of eye drops or artificial tears is essential to keep the affected eye properly hydrated and reduce the risk of corneal damage. To sleep, you should apply an ointment prescribed by the doctor and wear eye protection, such as a blindfold, for example.
People who experience pain associated with paralysis may also use an analgesic or anti-inflammatory, such as paracetamol or ibuprofen, for example.
How physiotherapy is performed
Physiotherapy uses facial exercises to strengthen muscles and improve facial movements and expressions. However, it is important that these exercises are performed several times a day, every day, to enhance the treatment. Therefore, in addition to sessions with the physical therapist, it is essential to do the exercises at home, and sometimes you can have sessions with a speech therapist as well.
Check out some examples of exercises that can be done for Bell's Palsy.