What is the matter with facial stiffness

Facial stiffness will have a certain impact on a person's life and social interaction, so it is necessary to pay attention to analyze and understand the cause. For example, idiopathic facial nerve paralysis or some viral infection can cause these symptoms.

1. Idiopathic facial nerve palsy

The main type of facial nerve palsy is idiopathic facial nerve palsy, often called Bell's palsy, which accounts for 60% to 75% of all facial nerve palsy cases. The most common is unilateral facial nerve palsy, which may be complete or incomplete. This diagnosis is considered after excluding other causes. Without treatment, the complete recovery rate of Bell's palsy is 71%, 13% of patients have only mild sequelae, and 16% of patients have moderate or poor recovery.

2. Infection

Infection is the second most common cause of facial nerve palsy. Common causes of infection include viruses, spirochetes and bacteria. Ratanaprasatporn et al. found in a 5-year study that approximately 5.7% of patients with facial nerve paralysis were caused by infection. Ramsay Hunt syndrome with herpes zoster is one of the most common causes of infection and is generally more serious.

This type of facial nerve palsy accounts for 12% of all facial nerve palsy, accompanied by varying degrees of cochlear nerve involvement, and about 20% of cases present with cochlear nerve and vestibular nerve symptoms. Other viral infections such as herpes simplex virus, measles virus, and cytomegalovirus (CMV) can also produce clinical symptoms similar to herpes zoster oticus.

3. Tumor

Tumors are the second most common cause after infection, and about 5% of facial nerve paralysis is caused by tumors. These tumors include acoustic neuromas, parotid gland tumors, primary cholesteatomas, and glomus jugularis tumors. In abnormal circumstances, both the tumor itself and surgical removal of the tumor can cause facial nerve paralysis. In the United States, the annual incidence of acoustic neuroma is about 1/100,000, while the incidence of parotid gland tumors is 5.8/100,000. From this, we can calculate that there are 17,200 cases of facial nerve paralysis caused by tumors in the United States each year, while in my country, using this ratio (1.3 billion × 6.8/100,000), the number is 88,400.

4. Neurogenic

The results of the study published by Ratanaprasatporn and May showed that facial nerve paralysis caused by neurogenic causes accounted for 5% of all facial nerve paralysis. There are many intracranial, non-traumatic neurogenic causes of facial nerve palsy as well as cerebrovascular diseases, which are the causes of facial nerve palsy. Ratanaprasatporn et al. found that about 2.5% of facial nerve paralysis was caused by cerebrovascular disease.