Facial nerve palsy steroid treatment

When your face is not working as it should, it is very tempting to try and force the muscles back to work by doing facial exercises. Never attempt to carry out exercises without professional help as you may do more harm than good. Most people want to do something but trying too hard may lead to problems later on in your recovery. There is evidence to suggest that exercising the facial muscles too forcefully can lead to a miswiring of the nerves as they recover, leading to longer term complications known as synkinesis. Your facial nerve is no different to any other part of the body and will take time to heal. Gentle facial massage is preferable to forceful exercises, using the pads of your fingers gently massage the brow, temples, cheek, chin and neck. If you are concerned about how your recovery is going after two to three months, ask your GP to refer you to a physiotherapist or speech and language therapist for assessment and treatment. They should have specialist experience in the management and treatment of facial palsy. Our self-help videos demonstrate techniques to help with your facial nerve recovery. Read more information about facial nerve recovery here: Facial Nerve Recovery .

Roughly, from the studies, it seems that if you do not take steroids you have about a 15 in 20 chance of full recovery of the nerve function. But, if you take a steroid medicine, you have about a 17 in 20 chance of full recovery. So, taking a course of steroids does not guarantee full recovery of the nerve function. However, it increases the chance of full recovery compared to no treatment. You should start the course of steroids as soon as possible after the onset of symptoms; ideally, within 72 hours of symptoms starting. They may not have much effect if they are taken after this.

LMN facial nerve palsy due specifically to varicella (herpes) zoster is Ramsay Hunt syndrome . Pain is often a prominent feature and vesicles are seen in the ipsilateral ear, on the hard palate and/or on the anterior two thirds of the tongue. It can include deafness and vertigo and other cranial nerves can be affected. When the rash is absent it is known as zoster sine herpete; 2-23% of people with Bell's palsy actually have Ramsay Hunt syndrome. [ 12 ] It should be suspected when pain is significant, especially in those aged over 60. Immunodeficiency - for example, HIV - is a risk factor.

A thorough medical history and physical examination , including a neurological examination , are the first steps in making a diagnosis. This alone may be sufficient to diagnose Bell's Palsy, in the absence of other findings. [3] Additional investigations may be pursued, including blood tests such as ESR for inflammation, and blood sugar levels for diabetes. If other specific causes, such as sarcoidosis or Lyme disease are suspected, specific tests such as angiotensin converting enzyme levels, chest x-ray or Lyme titer may be pursued. [3] If there is a history of trauma, or a tumour is suspected, a CT scan may be used.

To relax the cheek: (if the side of your mouth is pulling up and to the side, or your cheek feels tight)
Put your thumb inside your cheek at an angle toward the center of your ear. Grasp the outside of your cheek with your fingers, and pull down and forward (yes, it may hurt just a bit). Hold it for a minimum of 10 seconds; up to 30 seconds is good. Shift the position toward the center and repeat the stretch & hold. Shift still further toward the center and repeat. Shift the position to grasp at an angle from the jaw and pull forward and up; hold. Shift a bit toward the center below your lower lip and repeat.

Facial nerve palsy steroid treatment

facial nerve palsy steroid treatment

A thorough medical history and physical examination , including a neurological examination , are the first steps in making a diagnosis. This alone may be sufficient to diagnose Bell's Palsy, in the absence of other findings. [3] Additional investigations may be pursued, including blood tests such as ESR for inflammation, and blood sugar levels for diabetes. If other specific causes, such as sarcoidosis or Lyme disease are suspected, specific tests such as angiotensin converting enzyme levels, chest x-ray or Lyme titer may be pursued. [3] If there is a history of trauma, or a tumour is suspected, a CT scan may be used.

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