Causes of inflammatory damage to the trigeminal nerve
Factors contributing to inflammation of the trigeminal nerve are:
- surgical interventions on the jaw bones;
- fractures of the base of the skull, lower and upper jaws;
- tumors;
- complex tooth extraction;
- hypothermia;
- surgery on the maxillary sinus;
- improperly administered anesthesia;
- incorrectly performed dental prosthetics;
- metabolic disorders;
- the presence of foreign bodies that irritate the nerve trunk or injure nerve endings;
- bacterial or viral infection;
- various types of intoxication of the body;
- hypovitaminosis;
- weakening of the immune system.
Examination for facial nerve disease - find and eliminate the cause of the disease
The symptoms of facial nerve pain are almost the same in all cases, but its causes are different and require different treatments. Treatment “blindly” can delay the healing process. Therefore, in our clinic everything starts with searching for the exact cause and location of the nerve damage.
MRI of the brain, temporal bone. MRI scans show the brain centers of the facial nerve and its area of exit (root) to the base of the brain, blood vessels, and temporal bone. Circulatory disorders, cysts and tumors are easily recognized.
Blood tests to check for infections, biochemical changes that damage the facial nerve. The trigeminal nerve is a favorite area of attack by the herpes virus group. The suspicion of the presence of the virus and its activity can be easily verified using a blood test.
Electromyography, Blink reflex - measurement of electrical potentials of facial muscles. Helps assess the function of impulse transmission along the facial nerve, the degree of its impairment, judge the effectiveness of treatment, the presence of complications, and help in choosing the correct treatment tactics.
Stimulation electromyography of the facial nerve (electroneuromyography, myography of the facial nerve)
Symptoms of trigeminal neuritis
The maxillary trigeminal nerve consists of three types of nerve fibers:
- vegetative;
- motor;
- sensitive.
The symptomatic picture of neuritis may vary depending on which fibers were affected by the inflammatory process.
Damage to sensory fibers
In particular, with inflammation of the sensory fibers, the patient may complain of a tingling sensation, numbness, and weakened sensitivity in the area innervated by the trigeminal nerve.
Damage to motor fibers
When motor fibers are damaged, there is a partial or complete decrease in strength in the innervated muscles, their atrophy and deterioration of tendon reflexes.
Damage to vegetative fibers
When the vegetative fibers are inflamed, the patient experiences cyanosis and swelling of the skin, dryness and thinning of the skin, and the potential risk of developing a trophic ulcer increases.
Diagnosis of inflammation of the facial nerve
If the doctor is properly qualified, then only based on the patient’s complaints will he be able to make a diagnosis and identify the severity of the pathological process. But even if the clinical picture is typical, the patient will have to undergo a series of diagnostic examinations:
- take blood and urine tests;
- undergo magnetic resonance imaging;
- do electroneurography.
The results obtained will help determine what treatment for inflammation of the facial nerve will be. In addition, such an examination will allow the doctor to identify the body’s perception of non-steroidal anti-inflammatory drugs - these are the drugs that will be used for therapy.
Pain due to inflammation
In addition, a disease such as inflammation or neuritis of the facial trigeminal nerve makes itself felt with attacks of pain of a very diverse nature:
- cutting,
- burning,
- pricking,
- tearing
- shooting, etc.
In this case, the area of pain does not always correspond to the area of innervation and can spread to the lower jaw, cheeks and chin.
Pain may be accompanied by:
- muscle spasms (facial, chewing),
- the appearance of nasal discharge,
- development of hypersalivation,
- increased lacrimation.
Lack of sensation in the tongue, lips and chin
With inflammatory damage to the trigeminal nerve, not only the entire nerve can be damaged, but also its individual branches. This is why numbness and pain can occur in various areas of the face. For example, when the lingual branch of the nerve is inflamed, patients complain of pain and sensitivity disturbances in the anterior part of the tongue, and when the mental branch is damaged, in the area of the lips and chin.
Pain when laughing, chewing, brushing teeth and shaving
Pain due to neuritis of the maxillary trigeminal nerve can intensify with touching, chewing, laughing and with changes in temperature. That is why patients, trying to prevent the recurrence of painful attacks, avoid excessive mobility and prolonged conversations, and refuse brushing their teeth and shaving.
Treatment of the facial nerve at the Echinacea clinic
The treatment will be structured like this:
- Find and eliminate the factor that damaged the nerve (viruses, for example);
- Stimulate nerve regeneration.
If you neglect the first point, the chances of restoring the nerve are reduced, and the risk of facial contracture increases. The average duration of treatment is 2 months; you can complete most of the course at home on your own.
The planned result is restoration of the functioning of the facial muscles. Possible difficulties are advanced disease, significant narrowing of the facial nerve canal, damage to the myelin sheath of the nerve, leading to the appearance of a nervous tic of the eye, which to some extent complicates the treatment process. Read more about the causes and treatment of nervous tics.
Treatment of neuritis of the maxillary trigeminal nerve
Therapy
The treatment program for trigeminal neuritis is drawn up taking into account the causes of the disease and its clinical signs. The main goals of treatment are:
- achieving a sensitizing effect;
- fight against bacterial and viral infection;
- increasing the body's immune forces;
- elimination of swelling of the nerve trunk;
- restoration of natural adaptive and compensatory reactions;
- normalization of the patency of nerve impulses.
Healing procedures
The set of procedures aimed at blocking the inflammatory process and eliminating all manifestations of neuritis includes:
- antibacterial therapy;
- antiviral therapy;
- elimination of factors contributing to the occurrence of intoxication;
- removal of tumor-like neoplasms or dissection of adhesions compressing the nerve;
- prescribing vitamin and mineral complexes to the patient;
- stimulation of nerves and muscles;
- acupuncture;
- physiotherapy (electrophoresis, phonophoresis, UHF, ultrasound, paraffin therapy).
People suffering from trigeminal neuritis are advised to regularly visit dental clinics and have their oral cavity sanitized.
Reasons for development
Facial nerve neuropathy can develop for the following reasons:
- progression of herpes, polio, mumps, enterovirus;
- hormonal imbalances (the disease appears especially often in the first half of pregnancy);
- tooth infections;
- sudden and severe hypothermia;
- injuries of the skull and jaws;
- sinusitis, otitis;
- diabetes;
- poor circulation in the blood vessels of the face;
- multiple sclerosis.
Most often, the disease in question develops when the facial nerve is cold - a short stay in a draft is enough for the inflammatory process to begin its progression.
Advantages of the Health Energy Clinic
The Health Energy Clinic is a multidisciplinary medical center where every patient has access to:
- screening diagnostic programs aimed at early detection of diseases and pathologies;
- targeted diagnostics using modern equipment and laboratory tests;
- consultations with experienced specialists, including foreign ones;
- modern and effective comprehensive treatment;
- necessary certificates and extracts;
- documents and appointments for spa treatment.
Trigeminal neuralgia is a serious pathology that can seriously disrupt a person’s normal lifestyle. Don't let pain and fear take over your thoughts, get treatment at Health Energy.
Symptoms
The first attack of pain can be triggered by elementary things that no person can do without: laughter, smiling, articulation, brushing teeth, eating, frostbite on the face. Pain appears in one half of the face. At first, the painful attacks are short-lived. They end, just as they begin, abruptly. Over time, pain occurs more frequently and lasts longer. Often the pain begins to originate in the jaw and can be confused with toothache. Then the painful sensations move to the area of the cheek, ear, and forehead. There is lacrimation, paresis of the facial muscle, and the face becomes asymmetrical. After the attack, a period of remission occurs, which lasts several minutes. During remission there is no pain.
Symptoms
The main characteristic symptom of trigeminal neuralgia is paroxysmal pain. It comes suddenly and in its intensity and speed of spread resembles an electric shock. Typically, intense pain forces the patient to freeze in place, waiting for relief. The attack can last from a few seconds to 2-3 minutes, after which there is a period of calm. The next wave of pain may come within hours, days, weeks or months.
Over time, the duration of each attack of neuralgia increases, and periods of calm are reduced until a continuous aching pain develops.
The provoking factor is irritation of trigger points:
- lips;
- wings of the nose;
- eyebrow area;
- middle part of the chin;
- cheeks;
- area of the external auditory canal;
- oral cavity;
- temporomandibular joint.
A person often provokes an attack when performing hygiene procedures (combing hair, caring for the oral cavity), chewing, laughing, talking, yawning, etc.
Depending on the location of the lesion, the pain takes over:
- the upper half of the head, temple, orbit or nose if the ophthalmic branch of the nerve is affected;
- cheeks, lips, upper jaw – if the maxillary branch is affected;
- chin, lower jaw, as well as the area in front of the ear - with neuralgia of the mandibular branch.
If the lesion affects all three branches or the nerve itself before it is divided, the pain spreads to the entire corresponding half of the face.
Painful sensations are accompanied by other sensory disturbances: numbness, tingling or crawling sensations. Hyperacusis (increased hearing sensitivity) may be observed on the affected side.
Since the trigeminal nerve contains not only sensory, but also motor pathways for the transmission of impulses, with neuralgia the corresponding symptoms are observed:
- twitching of facial muscles;
- spasms of the muscles of the eyelids, masticatory muscles;
The third group of manifestations of neuralgia are trophic disorders. They are associated with a sharp deterioration in blood circulation and lymph outflow. The skin becomes dry, begins to peel, and wrinkles appear. Local graying and even hair loss in the affected area is observed. Not only the scalp suffers, but also the eyebrows and eyelashes. Impaired blood supply to the gums leads to the development of periodontal disease. At the time of the attack, the patient notes lacrimation and drooling, swelling of the facial tissues.
Constant spasms of muscle fibers on the diseased side lead to facial asymmetry: narrowing of the palpebral fissure, drooping of the upper eyelid and eyebrow, upward movement of the corner of the mouth on the healthy side or drooping on the diseased side.
The patient himself gradually becomes nervous and irritable, and often limits himself to food, since chewing can cause another attack.
If treatment does not bring results. Synkinesia and facial contracture
Facial symmetry returns in an average of 3 months. If your treatment has not brought results, facial asymmetry persists, pain or other symptoms appear, you should immediately clarify the cause of the dysfunction of the facial nerve. The location and cause of the nerve injury may not have been recognized and treatment was prescribed blindly. Perhaps little attention was paid to restorative procedures.
Facial synkinesis is a condition when, for example, closing the eye is accompanied by movement of the mouth and cheek, and smiling is accompanied by closing the eye, etc. Synkinesis occurs more often in cases of long-term, chronic disease of the facial nerve. Most often in these cases we find a chronic inflammatory process in the area of the nerve bed.
The most problematic complication of facial paralysis is contracture, i.e. cicatricial degeneration of facial muscles. The result of contracture is loss of elasticity and immobilization of the facial muscles, even after the function of the facial nerve itself has been restored. Contracture appears as a result of prolonged untreated paralysis of the facial muscles and/or as a result of inadequate recovery procedures (insufficient intensity of exercise or, conversely, excessive stimulation of the facial muscles). Facial contracture is partially reversible. We usually use local injections of the anti-scar drug Longidaza: we inject it with a very thin needle directly into the area of scarring of the facial muscles.
Prevention
Prevention of trigeminal neuralgia is a set of simple measures that significantly reduce the risk of developing pathology. Doctors recommend:
- undergo regular preventive examinations;
- at the first signs of the disease, seek help (the sooner treatment is started, the greater its effect will be);
- eat right, get the required amount of vitamins, minerals, unsaturated fatty acids;
- regularly engage in light sports and gymnastics;
- get enough sleep and rest;
- minimize stress and physical overload;
- avoid hypothermia and harden yourself;
- to refuse from bad habits.
Classification
Neuritis of the facial nerve can be primary or secondary.
The primary form of inflammation occurs as an independent disease in a healthy person due to hypothermia. This type of neuritis is called catarrhal neuritis.
The secondary form of inflammation develops against the background of infection, otitis media or another disease.
In the vast majority of cases, the disease is acquired, much less often it is congenital.
The congenital nature of the disease may be indicated by Melkersson-Rosenthal syndrome - swelling of the face combined with folding of the tongue.
Complications
Without treatment, trigeminal neuralgia gradually progresses. Over time, a pathological pain focus forms in one of the parts of the brain. As a result, the pain covers the entire face, is provoked by any minor irritant and even the memory of an attack, and subsequently becomes permanent. Vegetative-trophic disorders progress:
- irreversible atrophy of the facial muscles is formed;
- teeth become loose and begin to fall out due to advanced periodontal disease;
- baldness is increasing.
Due to constant pain, the patient's sleep is disturbed and severe depression develops. In severe cases, patients may commit suicide.
