Signs of facial nerve palsy

People with facial asymmetry, crooked mouth, and inability to close eyes may have Bell's palsy and should see a doctor.

The 7th cranial nerve is responsible for controlling the movement of one half of the face. Although this condition is not life-threatening, if not treated promptly, it can cause paralysis, affecting facial expression and aesthetics. The patient may experience facial imbalance, hemifacial spasms, incomplete eye closure, corneal ulcers, crooked mouth, etc.

Dr. Nguyen Xuan Thang, Head of the Department of Rehabilitation, Tam Anh General Hospital, Ho Chi Minh City, recommends that patients should see a doctor as soon as possible when they have signs such as not being able to keep water in their mouth when rinsing or brushing their teeth; feeling something in their eyes; and an unbalanced face, especially when laughing or talking.

Upon arrival at the hospital, the doctor will check the patient's clinical signs, including whether the patient can hold air in the mouth when puffing up the mouth; whether the philtrum is deviated; whether the natural wrinkles in the smile line and forehead on one side of the face are blurred or missing; check the tongue's sensation; whether the ear is ringing, painful, or has yellow discharge... In addition, the patient will also be instructed to perform other necessary tests.

Illustration of half of the face of a person with Bell's palsy (right) and normal face. Photo: Cleveland Clinic — Illustration of half of the face of a person with Bell's palsy (left) and normal face. Photo: *Cleveland Clinic*

Dr. Thang said that treatment methods vary depending on the cause and severity.

Use of medication

For people with facial nerve palsy of unknown cause, early treatment with corticosteroids is very important. The drug helps reduce inflammation and swelling, thereby minimizing nerve damage caused by inflammation.

In cases of viral disease, mainly shingles, the doctor may prescribe antiviral drugs for the patient. Nerve damage caused by shingles cannot be restored even if the virus is destroyed. Patients need to be treated within the first 72 hours to reduce the progression and risk of serious complications.

If the infection causes otitis media, leading to facial nerve palsy, the patient is treated with antibiotics.

Physical therapy

This is a treatment for all patients with facial nerve palsy, regardless of the cause. Physical therapy includes muscle exercises, massage, electrical stimulation... to restore muscle strength and coordination between facial organs, helping these muscles to function again soon after paralysis.

Surgery

Neuromuscular transfer and transplantation surgery helps restore some facial symmetry, ensuring aesthetics. This is a solution often applied to patients with facial nerve palsy who do not fully recover or recover poorly. Doctor Thang assessed this as a difficult technique, which needs to be performed by cosmetic microsurgeons.

Neurotransplant surgeon at Tam Anh General Hospital. Photo: Provided by the hospital — Neurotransplant surgeon at Tam Anh General Hospital. Photo: *Provided by the hospital*

Dr. Thang said that the symptoms of facial nerve palsy may not appear at the same time and vary in severity. However, patients should see a doctor early for timely treatment to avoid complications.

In daily life, you should avoid some habits that can lead to this condition such as sudden cold showers, showering after drinking alcohol... You need to keep your face and ears warm when exposed to strong winds and cold air. Control diabetes, high blood pressure, and dyslipidemia well. Get enough rest, limit staying up late or being overly stressed.

Phi Hong

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