Facial Nerve Paralysis: Treatment and Recovery Insights

Facial nerve paralysis

Hello, doctor.
About a year ago, I experienced facial nerve paralysis on the left side of my face, which recovered well and was almost fully healed.
However, two weeks ago, I developed similar symptoms on the right side of my face, with nerve paralysis.
Since I am not in Taiwan, I consulted a doctor in Japan who prescribed medication, including B12, two weeks ago.
Last year, a doctor in Taiwan prescribed steroids.
After two weeks, I still cannot make facial expressions on the right side; the paralysis sensation is less pronounced, but I experience pain at the tail of my eyebrow, cheek, and behind my ear when massaging my right face, and occasionally I feel dizzy.
Compared to last year, my recovery seems slower; at this time last year, I was already able to make slight facial expressions.
Should I return to Taiwan for an examination, or continue follow-up appointments in Japan? Thank you.

Yao Yao, 20~29 year old female. Ask Date: 2016/05/26

Dr. Jiang Junyi reply Neurology

Hello, based on your description, facial nerve paralysis may sometimes present with pain behind the ear, and there may be sensations of numbness or stiffness in the face.
Due to the inability to close the eyelids, tearing may also occur.
If the nerve damage is more extensive, patients may notice increased sensitivity to sound in the ear or a decreased sense of taste on the tip of the tongue.
Typically, the impact on facial muscles is quite widespread, although some symptoms may be localized.
The most important aspect of treatment is to initiate therapy as early as possible and to prevent complications.
The primary pharmacological treatment involves administering oral corticosteroids within one week of onset.
If a herpes zoster virus infection is identified, antiviral medication (Acyclovir) can be used in conjunction.
Other supportive therapies include the use of artificial tears and taping the eye shut at night to prevent exposure keratitis.
Once the neurological symptoms stabilize after a week, rehabilitation therapy can be arranged in the rehabilitation department.
It is advisable to consult a neurologist for discussion and treatment.
Wishing you good health and peace.
Dr.
Tao, Neurology, cares about you.

Reply Date: 2016/05/26

More Info

Facial nerve paralysis, often referred to as Bell's palsy when idiopathic, can be a challenging condition to navigate, especially when it affects one side of the face. Your experience of having previously recovered from left-sided facial nerve paralysis and now facing similar symptoms on the right side is understandably concerning. Here’s a comprehensive overview of the condition, treatment options, and recovery insights based on your situation.

Understanding Facial Nerve Paralysis
Facial nerve paralysis occurs when the facial nerve (cranial nerve VII) is damaged or inflamed, leading to weakness or paralysis of the muscles on one side of the face. Symptoms can include drooping of the mouth, inability to close the eye, loss of the sense of taste, and sometimes pain or discomfort in the ear or face. The exact cause of Bell's palsy is often unknown, but it is believed to be linked to viral infections, such as the herpes simplex virus.

Treatment Options
1. Medications: The use of corticosteroids, such as prednisone, is common in the acute phase of facial nerve paralysis. They help reduce inflammation and swelling around the nerve, potentially improving recovery outcomes. Vitamin B12 supplementation, as prescribed by your doctor in Japan, is also beneficial, as B vitamins play a crucial role in nerve health and regeneration.

2. Physical Therapy: Engaging in facial exercises can help strengthen the muscles and improve coordination. A physical therapist specializing in facial rehabilitation can provide tailored exercises to enhance recovery.

3. Alternative Therapies: Acupuncture and massage therapy may provide symptomatic relief and improve circulation in the affected areas. However, the efficacy of these treatments can vary from person to person.

4. Pain Management: If you experience pain in the affected areas, over-the-counter pain relievers or prescribed medications may help manage discomfort.

Recovery Insights
Recovery from facial nerve paralysis can vary significantly among individuals. While some may see improvement within weeks, others may take months. It’s important to note that the recovery process can be nonlinear; you may experience periods of improvement followed by plateaus or even temporary setbacks.

1. Timeline: Generally, most individuals start to see improvement within three weeks to three months. However, it’s not uncommon for some symptoms to persist for longer, and in some cases, residual effects may remain.

2. Follow-Up Care: Given your previous experience with facial nerve paralysis and the current symptoms you are experiencing, it would be prudent to continue follow-up care in Japan. If you feel that your recovery is not progressing as expected, or if you experience new or worsening symptoms (such as dizziness), it may be wise to consult a neurologist or an ear, nose, and throat (ENT) specialist for further evaluation.

3. Returning to Taiwan: If you have concerns about the treatment you are receiving in Japan or if you feel that a different approach may be beneficial, returning to Taiwan for a consultation could provide additional insights. However, ensure that you maintain continuity of care and do not interrupt your current treatment plan without professional guidance.

Conclusion
Facial nerve paralysis can be a complex condition, and recovery can take time. It’s essential to remain patient and proactive in your treatment approach. Continue to follow your doctor’s advice, engage in recommended therapies, and monitor your symptoms closely. If you have any doubts or if your condition changes, do not hesitate to seek further medical advice. Your health and well-being are paramount, and ensuring you have the right support and treatment is crucial for your recovery journey.

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