1, psychological care: the patient is mostly a sudden onset of the disease, it is inevitable that will produce tension, anxiety, fear of emotions, and some are worried about the face to change and ashamed to see the people and the treatment effect is not good and leave sequelae, this time, according to the patient's different psychological characteristics, patient patience to do a good job in explaining and consoling the work of channeling and relieving its tension, so that the patient's emotional stability and physical and mental state in the best state to accept the treatment and care in order to improve the effectiveness of treatment. The patient's mood is stable, the body and mind are in the best state to accept the treatment and care, in order to improve the therapeutic effect.
2, eye protection: due to incomplete eyelid closure or can not be closed, transient movements and corneal reflex disappeared, the cornea is exposed for a long time, easy to lead to intraocular infections, damage to the cornea, therefore, eye protection is very important, reduce eye use, go out wearing sunglasses to protect, and at the same time, drop some of the lubrication, anti-inflammatory, nutritive effect of the eye drops, sleep with an eye mask or cover the gauze block to protect.
3, local care: hot compresses to dispel the wind: to the end of the ginger local compresses on the side of facial paralysis, 1/2 hour a day; warm wet towel hot compresses on the face, 2-3 times a day, and morning and evening on their own *** the affected side, *** when the strength to be appropriate, the site of the accurate; as long as the affected side of the side of the muscle can be movement can be made on their own to do in front of the mirror wrinkled forehead, close the eyes, whistles, show teeth and other actions, each action to do 2 eight beat or 4 action, the movement to do 2 eight beat or 4 action. As long as the affected facial muscles can move, you can do wrinkling of forehead, closing of eyes, whistling, showing of teeth and other movements in the mirror by yourself, and each movement can be done in 2 eight beats or 4 eight beats, 2-3 times a day. In addition, patients with facial paralysis should pay attention to not wash their face with cold water, avoid direct wind, pay attention to weather changes, add clothes in time to prevent colds.
2. What are the preventive knowledge of facial paralysis
The occurrence of facial paralysis is often due to fatigue, nervousness or sweating after the body is weak, the body's resistance to decline, and the head and face by the wind and cold caused.
Facial paralysis this disease is more complex, it is because facial paralysis is very complex, so after suffering from facial paralysis patient's facial paralysis symptoms are also complex, we need to accumulate more knowledge of some facial paralysis, vigilance of the onset of this disease. So what are the preventive knowledge of facial paralysis? First, to prevent facial paralysis, first of all pay attention to keep warm, go out and try to wear a mask, avoid the cold wind on the face of the direct attack.
When you go out in cold days, you should pat, lightly press, behind the ears, some important points on the neck to increase your ability to protect yourself from the cold. When traveling by car, it is best not to roll down the windows.
Eat less or no frozen drinks or food, the old and weak, overworked, suffering from high blood pressure, arthritis, neuralgia and other chronic diseases should pay more attention. To face the work and life with optimism and calm mental state, reduce psychological pressure, avoid overwork.
If there is facial numbness and other discomforts, you should seek medical attention as soon as possible. Second, normal life rules.
Normal life rules must have a good sleep habits, early to bed and early to rise sleep habits, sufficient sleep time, will not let the eyes overworked. Third, do not use cold water to wash your face.
Many people use cold water to wash their face, long time cold water ***, it will make the facial nerve get damaged, thus inducing facial paralysis. Fourth, a good diet.
Eating habits are very important, greasy, not help digestion of food can not eat more, to eat more vegetables, fruits, these foods to supplement the energy supply of vitamins and nutrients, increase the ability to resist disease. Fifth, physical exercise.
Appropriate physical exercise on the prevention of facial paralysis has a great help, you can choose some suitable for their own exercise, such as tai chi, walking, etc., the intensity of the exercise should not be too large, long-term persistence, it will make your physique continue to enhance the prevention of wind-cold ability will be improved. The above mentioned is the prevention of facial paralysis knowledge are what the relevant explanation, I hope you can pay attention to the existence of facial paralysis.
After suffering from facial paralysis, you should also go to the hospital in time to receive treatment. We hope that you will pay attention to the prevention work in your daily life, then you will reduce the chance of suffering from this disease.
3. What are the main points of facial neuritis treatment
In the early stage, to improve the local blood circulation, eliminate the inflammation and edema of the facial nerve, and in the later stage, to promote the restoration of nerve function as the main principle of treatment.
(1) Hormone therapy. Prednisone or dexamethasone is commonly used.
(2) Improve microcirculation and reduce edema. Available 706 plasma or dextrose 40, can be added with dehydration diuretics.
, (3) the application of neurotrophic metabolic drugs. B vitamins, cytidine, coenzyme Q10 and so on.
(4) Physical therapy. Ultrashort-wave diathermy, infrared irradiation, transistorized pulse therapy.
(5) Acupuncture treatment. Take cataract, hearing, sun, dicang, Xiaguan, cheek car, and with Quchi, Hegu and other points.
(6) Vasodilators and cervical sympathetic ganglion block. Tolazoline and niacin can be used orally, and galantamine can be used to promote the recovery of nerve function.
4. How to prevent and treat facial neuritis
Facial neuritis refers to acute peripheral facial paralysis caused by acute non-suppurative inflammation of the facial nerve in the mastoid foramen of the stem, which is also known as facial nerve paralysis and Beier's palsy.
The main clinical manifestations of this disease are crooked corners of the mouth and peripheral facial paralysis, which can occur at any age, but is more common after middle age, is more common in men than in women, and often occurs on one side. It is a common disease, and the onset of the disease is not affected by the seasons.
[Pathogenesis] 1. Feel the wind and cold. Some patients can be due to the head and face wind or cold, resulting in local vasospasm, nerve tissue ischemia, edema, pressure and cause disease.
2. Infection. Some patients suffer from rheumatic diseases resulting in facial neuritis, or osteochondritis within the mastoid foramen of the stem, resulting in facial nerve swelling, compression, and blood circulation disorders caused by facial nerve palsy.
3. Reduced immune function. A small number of patients can also be due to the body's immune function is reduced, so that the facial nerve edema, myelin sheath or axons, such as varying degrees of degeneration, the formation of this disease.
Chinese medicine believes that this disease is due to the body's insufficient blood and qi, the veins are empty, wind, phlegm, fire and other evils paralyzed blockage of the meridians, so that the meridians are not conducive to the loss of nourishment of the tendons, qi and blood paralysis in the face of the traditional Chinese medicine "in the meridian", "? It is a disease of Chinese medicine, which belongs to the "middle meridian", "? [Clinical manifestations] 1. Sudden onset.
Patients often find the corner of the mouth leakage in the morning when washing, crooked, facial muscle paralysis, the symptoms in a few hours or 2~3 days to reach the peak, some patients in the first few days of the disease feel the sick side of the post-auricular, intra-auricular and facial with mild pain or pressure pain. 2. The corners of the mouth are skewed.
The nasolabial sulcus on the sick side becomes shallow, the corner of the mouth is drooping and crooked, and the corner of the mouth is obviously crooked to the healthy side when crying, laughing and showing teeth, often accompanied by a flow of Christmas, and the sense of taste is impaired or disappeared. 3. Facial muscle paralysis.
The patients showed paralysis of the expression muscles on the side of the face, disappearance of frontal lines, inability to wrinkle the forehead, frown, widening of the eye cracks, eyelids can not be tightly closed or closed incomplete, orbicularis oculi muscle reflexes are weakened or disappeared, corneal reflexes, transient reflexes such as hyporeflexes, the paralyzed side of the eyeballs turned to the upper inner side, can be exposed to the white sclera. 4. Food residue.
When eating and chewing, food is often left in the gap between the teeth and cheeks, and when puffing the cheeks and whistling, the affected side of the lips leaks air. 5. Hearing impairment.
Some patients may have different degrees of dullness of the auricle and external auditory canal, or hearing loss. 6. Sequelae.
Most patients have different degrees of recovery within 2 months after the onset of the disease, individual can be delayed until 1 year and cured, a small number of incomplete recovery can appear a variety of sequelae, such as facial myoclonus, the corners of the mouth to the affected side of the back, nasolabial folds become deeper, eyelid fissure shrinkage, the facial muscle involuntary twitching occurs, in the emotional excitement or nervousness is more obvious. [Preventive measures] 1. Avoid wind and cold.
Pay attention to the local warmth, go out or at night to avoid the wind and cold, in order to prevent the triggering of the disease. 2. Stabilize mood.
Do be happy, emotional stability, avoid mental tension, anxiety, impatience, as much as possible to participate in some recreational activities, in order to regulate the spirit, maintain a pleasant mood. 3. Combination of labor and leisure.
Adequate rest, to ensure a certain amount of sleep, but not too comfortable, should often participate in appropriate physical exercise, improve physical fitness. 4. Reasonable diet.
Usually on the basis of high protein, low salt diet, it is advisable to increase the intake of vitamins, choose a variety of animal foods, such as eggs, milk, fish, meat, etc., eat less sweets. In addition, you can always eat some coarse grains and bean products, such as corn, peanuts, soybeans, etc.; eat more fresh vegetables and fruits, such as carrots, green and red peppers, tomatoes, spinach, leeks, oranges, apricots, loquats, etc..
5. Treatment of other diseases. Due to certain infectious diseases or reduced immune function leads to the occurrence of this disease, therefore, we should actively take preventive and curative measures to eliminate various triggering factors in a timely manner.
[Treatment] 1. Western medicine. In the acute period of available prednisone, 10 ~ 20 mg per time, 3 times a day orally, 7 ~ 10 days after the drug can be gradually reduced according to the condition of the drug; can also be used with dexamethasone 10 mg intravenously, 7 ~ 10 days after the change to oral; selection of vitamin B drugs, with vitamin B1100 mg, intramuscular injection, 1 time a day, or orally each time 20 mg 3 times a day; can also be used with vitamin B12100 ~ 300 micrograms of vitamin B12100 ~ 300 micrograms, 1 time a day; can also be used with vitamin B12100 ~ 300 micrograms. B12100~300 micrograms intramuscular injection, once a day; oral sodium salicylate 0.3~0.6 grams each time, 3 times a day; or diprazole oral, 10 mg each time, 3 times a day.
2. Traditional Chinese medicine diagnosis and treatment. If the veins and channels are empty and the wind enters into the middle, manifesting as sudden askewness of the mouth and eyes, loss of facial expression on the affected side, shallow nasolabial folds, drooping of the corners of the mouth, drooling, accompanied by pain in the ears, it is advisable to add subtractions to the drafting of Zhengsheng San (10 grams of white aconite, 12 grams of white stalactites, 6 grams of scorpion, 3 strips of centipede, 15 grams of antifungal wind, 15 grams of dirondeum and 10 grams of rhizome of Chuanxiong) in order to disperse the wind and disperse cold, and invigorate the blood and channels. If the blockage of qi and blood is manifested as distortion of the eyes and mouth, facial twitching, lightening or disappearance of the forehead lines on the sick side, enlargement of the eye cracks, and the disease does not heal, use Angelica Blood Replenishing Soup combined with Peach Red Four Things Soup with additions and subtractions (raw Astragalus 30 grams, Angelica Sinensis 12 grams, red peony 12 grams, Rhizoma Ligustici Chuanxiong 15 grams, Radix Rehmanniae Sengdis 30 grams, Safflower 10 grams, Rhizoma Dioscorea 12 grams, Scorpion 6 grams, and Silkworms 12 grams) to benefit the vitality of qi and blood and dispel the wind to promote the channels.
3. Medicinal diet therapy. Facial muscle spasm, pain, can make homemade Chuanxiong Baizhi bighead carp soup, the practice is: 9 grams of Chuanxiong, 9 grams of dahuric dahurica, bighead carp head 1, add the right amount of water, with stewed until cooked, seasoned food.
4. Acupuncture treatment. In the paralyzed side take Yangbai, four white, cataract, dicang through the cheek car, the sun, Yingxiang, Xiaguan, save bamboo, Lianquan and other points; or use the electric needle *** corresponding points, such as dicang, cheek car, Yangbai, Hegu, etc., through the amount of electricity to the facial muscle beating, local comfort is appropriate, each time for 5 ~ 10 minutes.
5. Magnetic therapy. Take Fengchi, Yangbai, Zanzhu, Sibai, Xiaguan, cheek car, Dicang, Hegu and other points, each time to choose 3~6 points, each point is used alternately.
The specific method is: two high magnetic block as a pair of magnetic poles, one side of the contact skin points, the other side and pulse electrode wire connected, energized for 20 ~ 30 minutes, once a day or every other day. 6. Hot compress method.
Use angelica 9 grams, cinnamon sticks 9 grams, chicken blood vine 15 grams, 9 grams of wind, safflower 6 grams, peach kernel 9 grams, chuanxiong 9 grams, mulberry branches 15 grams, Tianxianteng 15 grams, Turbinaria 15 grams, 15 minutes of decoction, with a towel soaked through the juice of the medicinal compresses on the affected area while it is still hot, each time for 10 minutes, 2 to 3 times a day. 7. Acupuncture point poultices.
Take strychnine 0.5~1 grams, research into powder, scattered in Xiang Gui blood cream, pasted on the affected pressure points (sun, Xia Guan, cheek car and other points), every 2~3 days to replace. 8. Single prescription and proprietary Chinese medicine.
Take a live eel, decapitate the head to take blood, coated on the side of the face skewed, once a day, 3~5 days, but this method is only applicable to the early stage of the disease; can also be used with centipedes, scorpions, silkworms, the amount of 1:2:3, roasted and powdered, each.
5. Treatment of facial neuritis
Facial neuritis (Bell's palsy)
Overview
Facial neuritis, also known as Bell's palsy, refers to an acute non-septic inflammation of the facial nerve in the facial nerve canal above the foramen magnum.
Etiology
Facial neuritis is more common in cerebral neurologic disorders, which is related to the anatomy of the facial neural tube as a long, narrow, bony canal, which may be intrinsic to the pathogenesis of facial neuritis. The extrinsic cause of facial neuritis is not known. Some people speculate that it may be caused by cold wind blowing on the face, and the nutritive microvascular spasm of the facial nerve, causing local tissue ischemia and hypoxia. It has also been suggested that it is related to viral infection, but no virus has ever been isolated. In recent years it has also been suggested that it may be an immune response. The geniculate ganglion syndrome, on the other hand, is caused by herpes zoster virus infection, which causes inflammation of the geniculate ganglion and facial nerve.
Symptoms
It can be seen at any age, with no gender difference. It is mostly unilateral and rarely bilateral. The onset of the disease is not related to the season, usually acute onset, one side of the facial expression muscles suddenly paralyzed, can be a few hours into the peak. Some patients have pain in the postauricular mastoid area of the external auditory canal 1-3 days prior to the onset of the disease, and they often find it in the morning when they are washing or are found by others to have a crooked angle of the mouth. Examination shows the disappearance of forehead lines on the same side, inability to frown, due to paralysis of the orbicularis oculi muscle, the eye fissure is enlarged, and when the eyes are closed, the eyelids cannot be closed or are incompletely closed while the eyeballs rotate outwardly and expose the white sclera, which is known as Bell's phenomenon. The lower eyelid is ectropion, and the tears do not easily flow into the nasolacrimal duct and overflow out of the eye. The nasolabial folds become shallow on the sick side, the corners of the mouth droop, and the corners of the mouth are pulled toward the healthy side when showing teeth. When showing teeth, the corners of the mouth are pulled towards the healthy side. The patient cannot make pouting and whistling movements, and when puffing the cheeks, the corners of the mouth on the diseased side leak out, and when eating and mouthwashing, the soup leaks out from the corners of the mouth on the diseased side. Due to the paralysis of the buccal muscles, food often stays between the teeth and cheeks.
If the lesion affects the tympanic nerve, in addition to the above symptoms, there may be a loss of taste in the anterior 2/3 of the tongue on the same side. Involvement of the pedal muscle branch or above, due to the pedal muscle paralysis, at the same time can also appear ipsilateral auditory hypersensitivity. When the geniculate ganglion is involved, in addition to facial paralysis, dysgeusia and auditory hypersensitivity, there are also ipsilateral salivary and lacrimal gland secretion disorders, pain in the ear and behind the ear, and herpes zoster in the external auditory canal and auricular area, which is called geniculate ganglion syndrome.
Examination
1. Cerebrospinal fluid examination.
2. Electromyography shows spontaneous potentials and normal nerve conduction velocity.
3. Head and neck MRI may be normal.
Treatment
In the early stage, it is mainly to improve the local blood circulation, eliminate the inflammation and edema of the facial nerve, and in the later stage, it is to promote the recovery of nerve function as the main principle of treatment.
(a) Hormone therapy: prednisone (20-30mg) or dexamethasone (1.5-3.0mg) 1/d, orally, for 7-10 days.
(B) improve microcirculation, reduce edema: available 706 plasma or low molecular dextrose 250-500ml, 1 / d, 7-10 days, can also add dehydration diuretic.
(C) the application of neurotrophic metabolism drugs: vitamin B150-100mg, vitamin B12100μg, cytidine 250mg, coenzyme Q105-10mg, etc., intramuscular injection 1 / d.
(D) physical therapy: ultra-short-wave hyperthermia near the stems and breasts of the stoma, infrared irradiation, DC iodine ion implantation, in order to promote the dissipation of inflammation. The transistor pulse therapy machine can also be used *** facial nerve trunk to prevent facial muscle atrophy, reduce the paralyzed side of the muscle by the healthy side of the excessive traction of the muscle.
(5) Acupuncture treatment: take cataract, hearing, sun, dicang, Xiaguan, cheek car, and with Quchi, Hegu and other points.
(F) vasodilator and cervical sympathetic ganglion block: Tolazoline 25mg or niacin 100mg, oral, 3/d or cervical stellate ganglion block on the affected side, 1/d, for 7-10 days.
In addition to the above treatments, in the recovery period, vitB1 and vitB8 can be taken orally 10-20mg each, 3/d; diprazole 10-20mg, 3/d. Galantamine 2.5-5mg can also be used as an intramuscular injection, 1/d, in order to promote the recovery of nerve function.
In addition, to protect the exposed cornea, to prevent the occurrence of conjunctivitis, keratitis, can be used eye masks, eye drops, eye ointment and other methods. For those who do not recover for a long time can be considered for nerve transplantation treatment. Generally take the peroneal nerve or neighboring auricular nerve, with vascular muscle, transplantation to the facial nerve branch, counting the effective rate of about 60%.
The general prognosis is good, usually 1~2 weeks after the onset of the disease began to recover, within 2~3 months. About 85% of cases can be fully recovered without sequelae. However, those who have not recovered in more than 6 months have a poorer prognosis, and some may be left with facial muscle spasms or facial muscle twitching. In a few cases, the "crocodile tear sign", i.e., tearing of the eye on the diseased side during eating, may also occur on the diseased side. Electromyography and measurement of facial nerve conduction function are valuable in determining the extent of facial nerve damage and the degree of possible recovery, and can be performed two weeks after the onset of the disease.