Facial paralysis is a disease that almost all of us can encounter. Facial paralysis, which causes loss of movement in the facial facial muscles as a result of damage or compression of the facial nerve fibers (facial nerve), can be seen at almost any age. Nerve damage causes facial movement (mimic) loss, but also causes problems such as facial pain, headache and dizziness, earache, tinnitus, sensitivity to sound, difficulty speaking, and inability to hold in saliva. The facial nerve to the face can be compressed or compressed anywhere along its path.
There are two types of facial paralysis; Central Facial Paralysis (facial paralysis) and Peripheral Facial Paralysis (Bell's Palsy). In central facial paralysis, the nerve is damaged or compressed in the center, which can be caused by disorders in the brain (such as a tumor). Peripheral facial paralysis occurs as a result of compression or damage to any part of the nerve fibers leading to the face outside the central (brain). So how do we separate these two types? In the distinction of peripheral facial paralysis, since the facial nerve extends as separate branches to the left and right, in case of a problem, loss of strength in the facial muscles of the affected side (left or right of the face), atrophy may occur, or even complete loss of movement in the face, and the face may appear shifted to one side. While the facial nerve courses as a single branch in the brain, it divides into two in the peripheral part after the brain and innervates the left and right face, so both faces are affected in case of a problem in the center. When clinically evaluating patients, loss of movement in central facial paralysis is seen in the upper or lower part of both faces.
How do we know if we have facial paralysis?
Patients usually experience facial paralysis in the morning. He says that when he gets up and drinks water, water spills from one side of his mouth and he cannot control it. Some patients say that when they look in the mirror, they see that their face is shifted to one side and immediately consult a doctor.
We can understand that we have facial paralysis with this simple method; Stand in front of the mirror
Try to raise your eyebrows
Try to frown
Try to close your eyes
Brush your nose Try to blow
Try to blow
Try to open your lips with teeth together
Smile
Lift your jaw muscle upwards (the movement in which men lift their chins up while shaving)
Do each of the above movements. If there is a deterioration in facial symmetry in any or all movements and the face shifts to one side, if there is loss or weakening of movement, consult the hospital without delay.
Causes of Facial Paralysis
Facial paralysis. Although the most common cause is infections (Bell's palsy), there are many different reasons that can cause facial paralysis. The progression, treatment and rehabilitation of the disease differ depending on the cause.
-Surgical reasons
-Middle ear infection
-Viral infections (Bell's palsy and Ramsey Hunt Syndrome)
-Lyme disease
-Skull and facial bone fractures
-Trauma
-Neurological diseases (Multiple sclerosis, Gullian Barre etc.)
-Birth traumas
-Prenatal injuries occurring in the facial nerve developmental anomalies
-Stroke (Generally central facial paralysis)
-Genetic syndromes (Charge syndrome, etc.)
-Cancers
Facial Paralysis What to Pay Attention to to Avoid Occurrence?
Facial paralysis usually occurs in cold weather. Therefore, face protective clothing should be preferred when going out in winter. In summer, facial paralysis can occur when exposed to air currents, commonly referred to as drafts, so places where there is no air currents should be preferred while sleeping. Another cause of facial paralysis in summer is the air conditioner that produces cold air. For protection, places where air conditioners directly hit your body should be avoided. Another reason is the window that is opened while traveling. For protection, the window should not be opened in such a way that the wind directly hits our face.
How Does Facial Paralysis Affect Patients?
A patient suffering from facial paralysis should not be cosmetically damaged. The image will be distorted, which will negatively affect the patient's psychological, physiological and social life, as well as eye problems, difficulty sleeping, and problems in daily life due to the eye remaining open. Therefore, the patient's quality of life decreases. It may affect the quality of life and reduce the quality of life.
Studies have shown that 85% of Peripheral Facial Paralysis (Bell's Palsy) is cured. It is recommended to start treatment early to prevent nerve damage; Treatment should be started within 5 days after facial paralysis develops. Physical therapy must be taken to prevent permanent damage and to restore muscle function. Considering that most patients will recover without any treatment, care should be taken to keep the side effects of the chosen treatment method to a minimum. Treatment methods include general measures, physical therapy, steroid treatment, antiviral treatment and surgical decompression.
Eye protection: It occurs due to decreased tear secretion and loss of the blink reflex. Dry eyes make the patient very uncomfortable. The eye should be protected in all patients to prevent the risk of corneal injury and infection. For this purpose, artificial tear drops, antibiotic and moisturizing eye pomades are used, and the eye is closed with a grommet to prevent it from remaining open at night; Eye moisturizing during the day is provided by the use of transparent protective covers.
Psychotherapy: As the patient's cosmetic appearance deteriorates, most patients experience anxiety and pessimism. The treating physician or physiotherapist should be responsible for the patient's physical and cosmetic problems, as well as for the emotional and psychological dimensions of the disease. Therefore, the patient should be properly explained about the disease and should be motivated by explaining that the process of the disease is 85% recovery in approximately 2-3 weeks.
Physical therapy for facial paralysis
Infrared : Infrared ray is applied to the problematic side while protecting the eye. The aim here is to increase circulation and accelerate healing.
Electrotherapy: It is electrical stimulation applied by physiotherapists to the motor points of the facial muscles. In this way, atrophy in the muscles is prevented and forms the basis for facial exercises.
Facial massage: It is used to prevent atrophy of the facial muscles and to accelerate healing by increasing circulation. Massage The application should be done together with other physical therapy applications.
PNF (Proprioceptive Neuromuscular Facilitation): This is a technique used to teach muscles and nerves to work in harmony. It is based on the principle of creating movement on the sick side by resisting the movement on the healthy side.
Acupuncture: It is a frequently preferred method to provide muscle contraction recently.
Exercises for Facial Paralysis:
This is the key point of your treatment. It is vital to prevent muscle atrophy (decrease in muscle volume) and regain lost movement.
Exercises are basically done as follows; (All Movements Are Done in Front of a Mirror)
Eyebrows are raised, the problematic side is forced to do it voluntarily, the part that cannot be done is completed by hand, symmetrically with the other eyebrow.
Eyebrows are furrowed, the problematic side is forced to do it voluntarily, what cannot be done is completed by hand, symmetrically with the other eyebrow. The part is completed by hand, symmetrically with the other eyebrow.
The eyes are closed, the problematic side is actively tried to do it, but if it cannot, it closes the eyelid with its hand.
The nose is wrinkled, the problematic side is forced to do it voluntarily, the part that cannot be done is completed by hand, symmetrically with the other nose side. .
The lips are tried to be opened with the teeth closed (showing the teeth), the problematic part is tried to be done actively, the part that cannot be done is completed symmetrically by hand.
Blowing is tried, the problematic part is tried to be done actively, the part that cannot be done is done symmetrically by hand. is completed.
An attempt is made to smile, the problematic side is tried to be done actively, the part that cannot be done is completed by hand in a symmetrical manner.
The jaw muscle is wrinkled, the problematic side is actively tried to be done, the part that cannot be done is completed by hand in a symmetrical manner.
All these exercises can be done 8-10 times 3-4 times a day.
Other Recommendations: To get rid of facial paralysis in a shorter time, you can help develop muscles by chewing a lot of gum and inflating balloons during the day.
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