Definition
Facial paralysis, also called Bell's palsy, is a disorder that affects the nerve involved in the control of the facial muscles; when this nerve undergoes an inflammatory insult, it swells, causing a reflex stiffness in the face that prevents the correct use of the muscles of the site involved. Most often, paralysis affects only one side of the face; however, the disorder can involve the entire face.
Causes
Even if the specific cause is not entirely accredited, it seems that the facial paralysis is due to a viral insult: the etiopathological agent involved is Herpes simplex, the same virus responsible for genital and labial herpes. However, some sources they believe that facial paralysis is also favored by HIV infections, Lyme disease, sarcoidosis and middle ear infections.
- The subjects most at risk are children under the age of 15 and adults over 60; ideally, the disorder can occur at any age.
Symptoms
Patients with partial facial paralysis have a characteristic "one-sided smile" and evident difficulty in closing and opening one eye. Other signs accompanying the disorder include: altered taste, altered amount of tears and saliva, difficulty expressing the face, pain in the jaw and ear, hypersensitivity to sound, and rapid onset of muscle weakness in the muscles face them involved.
- Sometimes, paralysis can affect the entire face.
Facial Paralysis Information - Facial Paralysis Treatment Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Facial Paralysis - Medicines to Treat Facial Paralysis.
Medicines
Fortunately, in the majority of affected patients, facial paralysis tends to resolve itself shortly after its onset; often, the symptoms improve after a few hours and disappear after a few days or weeks. However, some facial paralysis occurs in a particularly abrupt way: in such situations, complete recovery can occur after a few months, also using the help of powerful drugs such as corticosteroids (prednisone) and antivirals (aciclovir or valaciclovir). the usefulness of drugs for the treatment of facial paralysis is not yet fully understood; however, it has been observed that their therapeutic effect is appreciable when pharmacological treatment begins from the very first symptoms.
Parallel to drug therapy, it is advisable to follow a physiotherapy process: massages and exercises aimed at the facial muscles prevent the paralysis from progressing and causing permanent damage. Physiotherapy is often essential to promote complete recovery in a short time.
In extreme cases, surgery (surgical decompression) is necessary, aimed at relieving the pressure on the nerve; if facial paralysis disfigures the face, it is advisable to intervene with facial plastic (rare).
The following are the classes of drugs most used in the therapy against facial paralysis, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
Corticosteroids: as we have analyzed, the so-called “idiopathic” facial paralysis tends to resolve itself in a few weeks (2-6). Administration of corticosteroids is sometimes recommended to prevent any neuritis; however, it should be noted that the approach with potent drugs of this kind makes sense only if the administration of the same begins within the first 3-10 days from the outbreak of the condition. Steroid-based drugs are indicated to reduce inflammation in load of the facial nerve, given their powerful anti-inflammatory effect.
- Prednisone (eg Deltacortene, Lodotra): the dosage must always be established by the doctor based on the severity of the facial paralysis and the patient's condition. Indicatively, the dose to be taken varies from 5 to 60 mg per day, possibly divided into several doses (1-4) over the course of 24 hours. Take the drug within 3-10 days of the onset of the first symptoms.
Antiviral drugs: when facial paralysis is related to an insult sustained by Herpes simplex, antiviral drugs can exert their therapeutic effect, especially if associated with corticosteroid therapy. In any case, the effectiveness of antiviral therapy for the treatment of facial paralysis is not fully accredited: some studies confirm its effectiveness, others deny it. It will be the doctor's duty to prescribe a similar treatment, based on the triggering cause, the severity of the condition and the general health of the patient.
- Acyclovir (eg Aciclovir, Xerese, Zovirax): the drug is an inhibitor of the DNA synthesis of herpetic viruses; it is therefore indicated for the treatment of facial paralysis of viral etiology, always associated with a steroid. Take one 400 mg tablet three times a day for 7-10 days, in full compliance with what your doctor prescribes.
- Valaciclovir (eg. Talavir, Valtrex, 500 mg or 1000 mg): indicatively, take one 250 mg tablet, three times a day, for 7-10 days. It is recommended that a steroid drug be combined with the antiviral.
- Famciclovir (eg Famvir): it is recommended to take a dose of 250 mg orally, twice a day. For patients also suffering from AIDS, increase the dose to 500 mg. The duration of therapy must be determined by the doctor. Combine a corticosteroid drug.
There are no scientific data on the use of antivirals alone for the treatment of facial paralysis. It is recommended to always combine a steroid.
Eye Moisturizing Medications: In the case of facial paralysis, the eye (or both affected eyes) struggles to close completely. To avoid xerosis (dryness) of the eye, it is strongly recommended to regularly apply specific eye drops or ophthalmic ointments that keep the surface of the eye moist. In some cases, it is advisable to cover the eye with a bandage during night sleep.
- Paraffin (eg. Lacrilube ophthalmic ointment): paraffin-based ointments are indicated to favor the lubrication of the eye, particularly when dry eye affects the epithelium of the cornea. It is recommended to apply the ointment just before bedtime, as the drug can cause temporary blurring of vision. Do not apply with contact lenses.
- Hypromellose (eg. Tioretin): this is one of the most suitable pharmacological treatments to remedy mild ocular dryness, in the context of facial paralysis. In order to obtain relief of symptoms in a short time, a frequent administration of the drug is recommended, approximately one application every hour for the first days of therapy.
- Acetylcysteine (eg. Tirocular, Brunac): it is possible to apply this mucolytic drug in the eye in the form of eye drops, in association with hypromellose, in order to restore the superficial layer of mucus in the eye, clearly altered by local xerosis caused by paralysis facial.
For further information: read the article on drugs for the treatment of dry eyes
