Facial Nerve Paralysis: Steroid Use and Recovery Insights

Q: Facial Nerve Paralysis: Steroid Use and Recovery Insights

Hello： Peripheral facial nerve palsy primarily affects the seventh cranial nerve. <br>The clinical symptoms include sensations of numbness or stiffness in the face. <br>Due to the inability to close the eyelids, tearing may also occur. <br>Sometimes, patients may notice an increa

Facial nerve paralysis

Hello, doctor! My father-in-law has been diagnosed with facial nerve paralysis...
but he only took steroids for one day and then stopped.
The doctor said that the inflammation of the nerve does not require further steroid treatment and that we should wait for rehabilitation to recover.
However, my father-in-law is very skeptical about this treatment! So I would like to ask you, is it necessary to take steroids for the treatment of nerve paralysis? How long should they be taken? By the way, my father-in-law's blood sugar spiked above 350 after taking the steroid dose for one day, and he usually has blood sugar issues! Could it be that his blood sugar problems are the reason for stopping the steroids?

Xiu Xiu, 30~39 year old female. Ask Date: 2019/05/28

Dr. Jiang Junyi reply Neurology

Hello: Peripheral facial nerve palsy primarily affects the seventh cranial nerve.
The clinical symptoms include sensations of numbness or stiffness in the face.
Due to the inability to close the eyelids, tearing may also occur.
Sometimes, patients may notice an increased sensitivity to sound due to a decrease in the ear's tympanic reflex, as well as a reduced sense of taste on the tip of the tongue.
The impact on facial muscles is usually extensive.
In the acute phase of facial nerve palsy, symptoms may take time to improve due to nerve damage.
The use of corticosteroids in the first week primarily serves to control inflammation and reduce the extent of nerve damage.
Other treatment options include medications such as vitamins and agents to improve blood circulation, as well as physical therapies like electrical stimulation, acupuncture, massage, low-level laser therapy, infrared irradiation, shortwave therapy, and facial muscle exercises.
Aside from corticosteroids, there is insufficient evidence to support the effectiveness of other treatment modalities.
After the acute phase, there are virtually no medications that have been definitively proven to be helpful, and patients are often advised to take vitamin B complex as an adjunct.
Approximately 10 to 20% of cases may not fully recover.
Regarding your mention of blood sugar issues, corticosteroids can often lead to hyperglycemia, so patients are typically advised to incorporate insulin injections and increase monitoring frequency during treatment to assist with blood sugar control.
I recommend that you consult a neurologist for further discussion and treatment.
Wishing you good health and peace.
Dr.
Jiang, Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2019/05/28

More Info

Facial nerve paralysis, commonly referred to as Bell's palsy when idiopathic, is a condition that can significantly impact a person's quality of life. The treatment approach often includes the use of corticosteroids, which are anti-inflammatory medications that can help reduce swelling and inflammation around the facial nerve. This is particularly important in the acute phase of the condition, where the nerve may be compromised due to inflammation.

In your grandfather's case, the decision to prescribe corticosteroids for only one day may seem abrupt, especially if he has concerns about the treatment. Typically, corticosteroids are administered for a period of 5 to 10 days, depending on the severity of the symptoms and the physician's assessment. The common regimen involves a tapering dose to minimize potential side effects. The rationale behind using corticosteroids is to reduce inflammation and potentially improve recovery outcomes. Studies have shown that early intervention with corticosteroids can lead to better recovery rates in patients with facial nerve paralysis.

However, the use of corticosteroids must be carefully considered, especially in patients with pre-existing conditions such as diabetes. Corticosteroids can cause an increase in blood sugar levels, which is particularly concerning for individuals with diabetes. In your grandfather's case, if his blood sugar levels spiked to 350 mg/dL after taking the medication, this could have prompted the physician to discontinue the corticosteroid treatment. Managing blood sugar levels is crucial, as uncontrolled diabetes can lead to further complications and hinder recovery.

It's important to note that while corticosteroids can be beneficial, they are not the only treatment option available. Other supportive therapies include physical therapy, acupuncture, and vitamin supplementation (particularly B vitamins), which may help in the recovery process. Some patients may also benefit from facial exercises to improve muscle coordination and strength.

Regarding the timeline for recovery, it can vary significantly from person to person. Some individuals may start to see improvement within a few weeks, while others may take several months. In some cases, complete recovery may not be achieved, and residual effects can persist. It's essential to have realistic expectations and understand that recovery can be a gradual process.

If your grandfather is experiencing significant doubts about his treatment plan, it may be beneficial for him to seek a second opinion from a neurologist or a specialist in facial nerve disorders. They can provide a comprehensive evaluation and discuss alternative treatment options that may be more suitable for his specific situation, especially considering his diabetes.

In summary, while corticosteroids are a common treatment for facial nerve paralysis, their use must be balanced with the patient's overall health status, particularly in the presence of conditions like diabetes. Ongoing communication with healthcare providers is crucial to ensure that the treatment plan is tailored to the patient's needs and that any concerns are addressed promptly.

Similar Q&A

Understanding Facial Nerve Paralysis: Symptoms, Steroid Side Effects, and Concerns

Hello Doctor, my daughter (15 years old) noticed on the afternoon of February 13 that she could not fully close her lips when drinking water, and her right face felt stiff when she opened her mouth wide. She visited the doctor on February 14 and was prescribed steroids and stomac...

Dr. Jiang Junyi reply Neurology
Hello, You Ma: You mentioned that "when drinking water, your lips cannot fully close, and your right face feels stiff when your mouth is wide open." You have been taking steroids and gastric medication for a week. Clinically, this may suggest facial nerve paralysis. In...

Effectiveness of Steroid Treatment for Facial Nerve Paralysis

Dr. Gao: Hello! My mother has been living in Shanghai, China, and she experienced facial nerve paralysis in early May, with symptoms including lower eyelid drooping and eversion, drooling while eating, pain behind the ear, and loss of taste at the tip of her tongue. She has a his...

Dr. Gao Chunde reply Neurology
The use of steroids is effective in reducing inflammation and edema during the early stages of the disease, typically for seven to ten days. After that, rehabilitation and acupuncture are relied upon. Your physician's approach may have specific considerations, and if you hav...

Understanding Facial Nerve Paralysis: Rehabilitation and Treatment Options

Dear Dr. Chen, My father has a distortion on one side of his face, and there have been significant changes in his facial expressions. He is unable to whistle, saliva is leaking from the corner of his mouth, he has taste disturbances, and there have been changes in his hearing. T...

Dr. Chen Xianchang reply Rehabilitation
1. Early administration of corticosteroids can reduce inflammation and prevent the condition from worsening. 2. Generally, it can be classified into viral causes and Bell's palsy (of unknown origin), with some patients possibly experiencing mild residual symptoms. 3. Phy...

Understanding Facial Nerve Paralysis: Treatment and Recovery Insights

Hello Doctor, two weeks ago I noticed symptoms of left facial nerve paralysis: I cannot close my eye, my mouth cannot open, my face cannot move, and sounds in my ear are excessively loud. A neurologist prescribed steroids and also performed acupuncture and electrical therapy. Cur...

Dr. Jiang Junyi reply Neurology
Hello, Sir: You mentioned that facial nerve paralysis affects hearing. This is because the stapedius muscle, which is responsible for stabilizing the stapes bone, is innervated by the facial nerve. Recovery of symptoms requires nerve regeneration, unlike facial muscles that can i...