Facial neuropathy

Facial neuropathy most often occurs as a result of hypothermia, facial trauma, an infectious disease, stressful situations, on the background of blunt immunity. It can develop as a complication of otitis, tympanitis, parotitis, dental disorders, diabetes, and herpetic infection. The most vulnerable part of the facial nerve is its segment, located in a narrow curved canal (in the temporal bone pyramid) about 3 cm long. The predisposing factor may be inborn anatomical narrowness of this channel.

This disease is also called “Bell’s palsy”, in honor of the scientist who first described this type of neuropathy in 1836.

The clinical findings of facial neuropathy are characterized by paresis or paralysis of the facial muscles on the affected side (prosoplegia).

The diagnosis can already be visually determined – a pronounced asymmetry of the face is characteristic, nasolabial folds and forehead folds are smoothed on the affected side, the cheek “sails”, and the mouth angle is lowered. A person cannot close his eyes tightly, wrinkle his forehead, frown, whistle, and bare his teeth.

Depending on the facial nerve lesion level, clinical picture will be somewhat different. The higher the lesion level is, the more extensive the symptoms will be.

For example, in case of facial nerve damage in the bone canal before the branching of greater petrosal nerve, the paresis of facial muscles will be accompanied by dry eyes (xerophthalmia), a taste perversion on the front tongue part, salivation disorders and sound hyperesthesia (hyperacusia). In case of facial nerve damage before the branching of nerve to stapedius, the same symptoms will be observed, but instead an increased lachrymation is observed (“crocodile tears” symptom).

All of these can be accompanied by painful postaural sensations – this is a characteristic feature of the disease beginning. A facial muscles palsy/paralysis develops within 1 or 2 days (disordered facial nerve motor function).

Facial nerve neuropathy is a common disease of the autonomic nervous system which takes the 2^nd place after vertebral disorders.