Neuritis of a facial nerve

Description:

Neuritis of a facial nerve meets various frequency in regions of the country, especially during the cold periods of year, at any age, is equally frequent at persons of both sexes.

Symptoms of Neuritis of a facial nerve:

The clinical picture of defeat of a facial nerve is generally characterized by sharply developed paralysis (paresis) of mimic muscles. Seldom (about 2% of cases) bilateral damages of a nerve meet. At the beginning of a disease slight or moderate pains and paresthesias in an ear and a mastoid can develop. Usually pains arise along with paresis or in 1-2 days prior to its development. Pains are characteristic of defeat of a facial nerve to an otkhozhdeniye of a drum string. Especially severe pains are noted at defeat of a facial nerve at the level of an arrangement of a node of kolenets.

The clinical picture depends on the level of defeat of a facial nerve. At pathology in a kernel zone (a pontinny form of poliomyelitis) at patients only the phenomena of paralysis of mimic muscles develop. At defeat of a root of a facial nerve in the bridge of a brain near a kernel of the taking-away nerve weakness of a direct outside muscle of an eye joins paresis of mimic muscles (quite often it happens at trunk strokes to development of an alternating syndrome of Miyyara-Gubler). If the facial nerve is broken in the field of its exit from a brainstem, the clinical picture consists of a combination of symptoms of dysfunction VII and VIII pairs of cranial nerves. Especially often these two nerves are switched off at a neurinoma (shvannoma) of the VIII couple in a zone of an internal acoustical entrance, the clinical picture is combined with gomolateralny deafness. Defeat of a facial nerve in the bone channel of a pyramid of a temporal bone to an otkhozhdeniye of a big superficial stony nerve, except paralysis of mimic muscles, is followed by reduction of a slezootdeleniye up to dryness of an eye (xerophthalmia) and disorders of taste, salivation and a hyperacusia. Pathology of this nerve to an otkhozhdeniye of a stapedial nerve gives the same symptoms, however instead of dryness of an eye there is dacryagogue. At defeat below an otkhozhdeniye of a stapedial nerve of a hyperacusia it is not observed. In cases of switching off of conductivity of a nerve in a zone of its exit from a stylomastoid opening motive frustration prevail.

Reasons of Neuritis of a facial nerve:

The infection is the most frequent reason of development of defeats of a facial nerve. Cooling (driving in the car with an open window, a dream near an open window leaf, etc.) can be a provocative factor. Injuries, disturbances of arterial circulation matter at a hypertension, atherosclerosis of vessels of a brain, etc. Selective defeat of a facial nerve at a circulatory disturbance in a vertebral artery is noted. Sometimes defeat of a facial nerve arises as a complication of otitis, parotitis, inflammatory, neoplastic and other processes on the basis of a brain. The Pontinny form of poliomyelitis is shown by clinic of neuritis of a facial nerve. In dental practice there can sharply be paralysis of a facial nerve at anesthesia of the lower alveolar nerve.

Treatment of Neuritis of a facial nerve:

At acute neuritis appoint antiinflammatory, antiedematous, spasmolytic and vasodilators. At a pain syndrome use analgetics. From anti-inflammatory drugs apply glucocorticoids (Prednisolonum). It is noticed that in cases of introduction of glucocorticoids contractures of face muscles usually do not develop.

Further medical actions have to be directed to acceleration of regeneration of the struck nerve fibrils and recovery of conductivity which remained the prevention of an atrophy of mimic muscles, prevention of contractures. From the 5-7th day of a disease appoint thermal procedures: paraffin, ozokeritovy and mud applications on the healthy and struck sides of a face. Acupuncture, and also ultrasound with a hydrocortisone on area of a mastoid gives good effect (the iglorefleksoterpiya is usually carried out without combination to any version of physiotherapeutic procedures). At slow regress of paresis appoint the substances influencing fabric exchange, - Nerobolum or nerobolil improving a metabolism (preferential proteinaceous and calcic) and the reducing catabolic processes. Apply also group B vitamins, antikholinesterazny drugs (прозерин, Galantaminum, Nivalinum), Dibazolum, strychnine. In the subacute period appoint remedial gymnastics and massage of mimic muscles. In the absence of effect of medicamentous therapy 8-10 months later and identification of electrophysiologic reaction of degeneration of a facial nerve it is reasonable to discuss with the neurosurgeon a question of surgical treatment, including autotransplantation of nerves.