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What is the Facial Nerve?
The facial nerve is otherwise known as the seventh cranial nerve. There are twelve, paired cranial that emerge from the brain stem and extend through openings in the skull in order to innervate their corresponding structures in the head and neck. The cranial nerves, like spinal nerves, help link the central nervous system to the periphery. Each cranial nerve is numbered with a Roman numeral and individually named.
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What does the Facial Nerve do?
The facial nerve (CN VII) provides motor control to the muscles of facial expression, has partial control in taste (front two thirds of the tongue), a general sensory function to the ear canal and the control of glands that affect the secretion of tears and mucous to the nasal passage and mouth.
Bell’s Palsy
Temporary facial paralysis resulting from trauma and inflammation to one of the two facial nerves is frequently referred to as Bell’s Palsy. It is the most common cause of facial paralysis. It typically affects one side of the face causing a range of signs and symptoms. Usually it presents suddenly and reaches a peak within 48 hours.
Bell's Palsy affects around one in 4,000 people in the UK each year and around one in 70 people in a lifetime. It can occur in people of all ages, but most commonly between the ages of 15 and 45.
It is more likely to occur with other health complications such as Diabetes, chronic respiratory conditions or those with compromised immune systems.
Typical situation
- Waking up one morning and finding that your face feels stiff and odd.
- When you look in a mirror, half your face appears to droop.
- You can only manage half a smile
- Your eye is dripping tears and doesn't want to close.
For many people, the first thought is that that they have had a stroke. One distinguishing factor between this and a stroke is its focused effect of weakness or paralysis to the face only.
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Causes
Though there are no conclusive specific causes it is often attributed to viral infections such as viral meningitis, herpes simplex (cold sore virus), herpes zoster (chicken pox and shingles) or the Epstein-Barr virus. It is thought that the paralysis develops as the facial nerve swells and becomes inflamed in reaction to the infection.
The facial nerve has a narrow canal or space through which to pass on route to the different parts of the face. Any impingement on the amount of space the nerve can damage the protective covering of the nerve and interfere with communication between the nerve and your facial muscles.
For most people, Bell's Palsy symptoms begin to improve within a few weeks, with complete recovery within three to six months. Between 8% and 10% will experience a recurrence of the signs and symptoms, sometimes on the opposite side of the face. A small number of people never fully recover and continue to have some signs and symptoms for life (www.mayoclinic.com).
Signs and symptoms to look out for:
- Sudden onset of paralysis or weakness on one side of your face, making it difficult to smile or close your eye on the affected side
- Facial droop and difficulty with facial expressions e.g. pursing the lips, frowning, smiling.
- Pain behind or in front of your ear on the affected side
- Sounds that seem louder on the affected side
- Pain, usually in the ear on the affected side
- Headache
- Loss of taste
- Changes in the amount of tears and saliva your body produces
Some of these symptoms can also be caused by other conditions such as a stroke, tumours and infections so immediate advice from a GP or specialist is very important.
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Testing
There is no diagnostic test specific to Bell’s Palsy. Tests such as electromyography (measures electrical activity in muscle to determine any nerve damage), MRI and CT scans (detailed images of skeletal and soft tissues structures) are recommended if a conclusive diagnosis cannot be made.
Conventional medication
Medication may be recommended to help speed recovery time. However, study results have been mixed regarding the effectiveness of two medications commonly used to treat Bell's palsy; corticosteroids and antiviral drugs.
Corticosteroids, such as prednisone, have powerful anti-inflammatory effects. If the swelling of the facial nerve can be reduced, it will fit more comfortably within the bony corridor that surrounds it. If Bell's Palsy is triggered by a virus, then an antiviral may stop the progression of the viral infection. Some clinical studies show benefit from early treatment with corticosteroids, antivirals or a combination of both types of drugs; other studies do not. Evidence of the effectiveness of corticosteroids appears to be stronger than that for antiviral drugs (www.mayoclinic.com).
Alternative treatments
Depending on the severity of symptoms and underlying nerve damage, a range of other alternative therapy approaches may help.
- Relaxation techniques
- Facial massage
- TENS machines
- Acupuncture
- Homeopathy
- Nutritional support
Remember, as with all injuries or conditions it is important to seek advice from your GP or Chiropractor for a correct diagnosis before starting any treatment programme.
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