How to treat facial nerve paralysis

Facial nerve paralysis, which we usually call facial palsy, is a common facial nervous system disease. The specific symptoms mainly refer to the patient's facial paralysis, drooling, and unclear speech. The harm to patients is relatively large, because it will cause damage to facial expressions and often have a great impact on patients' psychology. In the acute stage, we must first improve the patient's blood circulation and prevent edema, so as to reduce the pressure on the nervous system. We can use some corticosteroids and other drugs for treatment. After the acute stage, we must promptly carry out recovery period conditioning and treatment, such as some physical therapy methods, which will have better effects, such as acupuncture and massage.

1. Acute Phase

Onset is within 1-2 weeks. The main focus of this stage is to control inflammatory edema, improve local blood circulation, and reduce nerve compression. Commonly used drugs are:

1. Use corticosterone drugs to reduce facial nerve edema. Take oral prednisone tablets from the day of onset, three times a day, with a daily dose of 45-60 mg. Gradually reduce the dose after 3 days, not exceeding 10 days. Dexamethasone 10 mg can also be administered by intravenous drip once a day.

2. Take vasodilator niacin tablets orally, 100 mg, three times a day; or take dimethoate tablets orally, 20-30 mg, three times a day.

3. Take aspirin tablets orally, 0.5~1g, twice a day.

4. Vitamin B1 100vmg, intramuscular injection, once a day; Vitamin 12 1000μg, intramuscular injection, every time.

5. Give antiviral drugs such as Banlangen, Virolin, and Ribavirin as appropriate.

2. Recovery Period

2 weeks to 2 years after onset. The treatment at this stage is mainly to restore nerve conduction function and strengthen muscle contraction as quickly as possible. In addition to continuing to give vitamins B1 and B12, the following measures can be taken:

1. Galantamine 2.5 mg intramuscularly, once a day; or neostigmine tablets 60 mg orally, three times a day.

2. Physical therapy electrical stimulation, electric massage, etc.

3. Stimulate the Dicang, Yifeng, Taiyang, Fengchi, Hegu, Zusanli and other acupoints with strong stimulation.

4. Pay attention to eye protection, such as wearing glasses, using sterile liquid paraffin eye drops, eye drops and antibiotic eye ointment, etc.

5. Some people advocate that if facial paralysis shows no signs of recovery after one month, facial nerve canal decompression surgery should be considered, but it is only effective for patients whose lesions are located within the facial nerve canal.

Sequelae period: If facial paralysis cannot be recovered after 2 years, the patient can be treated as having permanent facial nerve paralysis and undergo plastic surgery such as nerve anastomosis and free nerve transplantation.