Impressive, the facial paralysis however, does not always have a serious cause. A simple reactivation of the herpes labialis virus can sometimes explain this disturbing medical condition. As if an unsightly cold sore wasn’t already enough of a gift from this damn virus.
Half of the face is frozen, the eye is permanently open, the eyelid and the corner of the lips droop. It is without batting an eyelid that affected patients face this situation.
The course of facial paralysis depends on its cause. When it is idiopathic (without known origin) or linked to a herpes virus, it generally disappears within weeks of the onset of symptoms. Relapses are still possible. Complications and sequelae are more frequent when the disease is the result of trauma, infection, general illness or even a tumour.
Treatment involves addressing the cause of the facial paralysis. Medicines can be prescribed. The prevention of ocular complications (which are the consequence of a permanently open eye) must be essential.
Central or peripheral paralysis: quecaso?
Facial paralysis is the result of a facial nerve damage. This complex nerve starts from the bottom and the back of the brain, crosses the petrous bone (located behind the ear) and branches out at the level of the face.
We are talking about peripheral facial paralysis when the outer part of the facial nerve is affected. In this case, the upper and lower face are affected by facial paralysis. Note that there is a facial nerve which controls the right part of the face and another facial nerve which controls the left part, which is why the paralysis only affects half of the face depending on the location of the nerve. damage to the outside of the nerve.
On the other hand, the central facial paralysis is the consequence of an attack on the part of the facial nerve which is inside the brain. In this case, the upper face is usually not affected by the paralysis. On the other hand, neurological disorders may appear and/or a part of the body may be paralyzed. Central facial palsy usually appears in a context post stroke (cerebrovascular accident) or a brain tumor.
What are the causes of facial paralysis?
In the vast majority of cases, facial paralysis is said to be idiopathic (without known cause). Sometimes it is the result of trauma or another disease.
Idiopathic in 72% of cases (Bell’s palsy)
In nearly 72% of cases, facial paralysis would have no known cause, it is called idiopathic facial paralysis or paralysis from the cold or Bell’s palsy.
This form of paralysis sets in suddenly and spontaneously. Nevertheless, it seems that it is often linked to a reactivation of a herpes virus affecting the face (cold sores (HSV1) or herpes zosterwhen it causes shingles). The mechanism of facial paralysis from the cold would then probably be a facial nerve edema secondary to a herpes viral infection.
What can cause facial paralysis?
However, in less than 30% of cases, facial paralysis is explained by an event such as:
- A trauma (stone fracture, parotid wound, after-effects of facial surgery, complications of difficult childbirth in infants). In this case, the facial nerve would be damaged.
- An infection in the face or neck (otitis, mastoiditis…), meningitis, HIV, Lyme disease…). the damage to the facial nerve would be explained by its swelling secondary to the infection.
- A benign or malignant tumor in the face or neck (meningioma, cholesteatoma, acoustic neuroma, parotid tumor…). The facial nerve would then be compressed.
- Other chronic general illnesses which can lead to dysfunction of the peripheral nervous system (neuropathies) like a diabetes, the multiple sclerosisthesarcoidosis or the polyradiculonewritten.
Some figures of facial paralysis
- Each year, approximately 20,800 people are diagnosed with facial paralysis.
- In 72% of cases, facial paralysis is idiopathic (about 15,000 spontaneous cases per year).
- As many women as men are affected.
- The average peak of onset is around 40 years of age.
What are the symptoms of facial paralysis?
THE symptoms of facial paralysis most often set in suddenly and quickly except where it is the consequence of a chronic general condition such as diabetes. In this case, some warning signs are present as un numbness of parts of the face.
Half of the face is frozen and the person appears expressionless:
- The forehead is smooth and the patient cannot frown or raise an eyebrow ;
- The eye is always open or half-open. The patient can’t close or blink an eye ;
- Theeyelid droops falls or even is turned over (ptosis);
- The eye may be dry or on the contrary tearful;
- The mouth and corner of the lips hang down and the patient cannot open or move one half of the mouth and lip. The patient may experience difficulty eating, drinking and speaking. The mouth may be dry and the altered taste.
- The bridge nasogénien is no longer marked;
- The patient no longer feels his ear when he touches her and sounds can be increased.
How long does facial paralysis last?
The duration of facial paralysis depends on its cause. When idiopathic, recovery occurs gradually over 1-2 months. On the other hand, in the event of a known cause such as trauma or illness, the paralysis can last for several months.
Is facial paralysis serious?
The severity of the disease depends on the nature, location and severity of the facial nerve involvement. If this is not injured (in the case of idiopathic or infectious paralysis), the disease is mild and the chances of complete recovery are optimal.
If the nerve is compressed (as in the case of a tumour), the prognosis is favorable if the cause is treated (for example by removing the tumour).
In the event of trauma, recovery can be total or partial with sometimes permanent sequelae (lack of mobility, facial hemispasms, synkinetic movements, crocodile tear syndrome, etc.).
If facial paralysis is the consequence of a chronic disease such as diabetes or multiple sclerosis, the prognosis is uncertain. Without management of the causative condition, the paralysis can become chronic or worsen.
Recurrences of facial paralysis are always possible.
How is the diagnosis of facial paralysis made?
The diagnosis of facial paralysis goes through a simple physical examination by the attending physician. Other specialists are then involved in the precision of the diagnosis and the management: ophthalmologist, neurologist, ENT, etc.
Of the Additional tests may be prescribed:
- bilan sanguin;
- ENT assessment (hearing test, tympanometry, study of stapedial reflexes, etc.);
- ophthalmological assessment (examination of the cornea);
- neurological assessment: electroneurography, electronography;
- imaging (scanner, MRI, etc.).
How to treat facial paralysis?
A figori facial paralysis requires taking certain medications. The treatment of other types of paralysis involves treating their cause.
Medicines for cold facial paralysis
In case of idiopathic facial paralysis (Bell’s palsy) the treatment involves taking certain medications such as:
- Of the high doses of corticosteroids from the first symptoms;
- The wearing an occlusive dressing as well as the application of a eye drops and one antiseptic ointment on the eye. these treatments make it possible to avoid ocular complications such as keratitis (linked to ocular dryness itself explained by the fact that the eye is always open). Sometimes surgery is possible to protect the cornea.
- And antiviral therapy with valaciclovir may be prescribed if the herpes virus is involved.
Cure another form of facial paralysis
Treatment for facial paralysis depends on its cause.
- Treat an infection with antivirals, antibiotics…
- Treating a tumor that compresses the facial nerve by removing it surgically or with chemotherapy…
- Managing a general illness such as diabetes or multiple sclerosis…