Treatment of facial nerve neuritis. Drugs for treatment, hormones

According to statistics, the fairer sex is most often affected by neuritis of the facial nerve. In addition, studies have shown that people 25-35 years old are more susceptible to the development of pathology. The disease is dangerous for its complications, so if the muscles on one side of the face have stopped moving, you must immediately contact a neurologist, not hoping that the problem will disappear on its own.

After a thorough diagnosis, the doctor will select a treatment regimen and recommend effective drugs that will help get rid of inflammation.

Description of the disease

Neuritis of the facial nerve is an inflammatory pathology that is unilateral. In this case, the facial nerve, which regulates the work of the facial muscles, is affected.

The disease develops gradually. First, there is pain behind the ear, and after 1-2 days the face becomes distorted and becomes asymmetric, which is especially noticeable when a person laughs or cries, tries to puff out their cheeks or show your teeth. In addition, there are problems with closing the eyelids on the affected side, and this, in turn, leads to dry eyes, watery eyes. Also, the taste on one side of the tongue is disturbed, hearing decreases or becomes more acute.

Depending on the causes of development, the disease can be:

• Traumatic. May occur after traumatic brain injury. Also, the cause is sometimes a birth injury or hypoxia during gestation.
• Infectious (herpetic, respiratory). It develops as a complication of viral infections.
• Ischemic. The cause of the pathology is a violation of blood circulation in the area of ​​the facial nerve.
• Compression. It occurs when the skull is squeezed by neoplasms.

This pathology is dangerous for its complications.

If you do not take up treatment in time, you may experience problems such as:

• Immobility of the muscles of the face (when the treatment is started out of time or the drugs are incorrectly selected, due to severe damage to the nerve, the movement of the muscle cannot be restored).
• Synkinesia (when trying to smile, an involuntary narrowing of the palpebral fissure occurs).
• Partial or complete blindness (one of the signs of pathology is dry eyes, if the problem is left unattended, damage to the cornea is possible, leading to blindness).

Basic principles of traditional treatment

Treatment of neuritis of the facial nerve (drugs should be selected by a doctor) should be started immediately. A neurologist can recommend hospitalization, but outpatient therapy under the constant supervision of a physician is also possible. The earlier treatment is started, the more chances you have to fully recover, restoring the ability to move the facial muscles. If nerve atrophy occurs, then the transmission of impulses cannot be restored. Treatment will take a long time, in some cases - at least 6 months.

The main goal of therapy is to stop the inflammatory process, eliminate edema. During the first week, the affected muscles should be at rest. Treatment is carried out with the help of dehydrating agents, vasodilators, B vitamins. If there is an inflammatory process and the patient suffers from pain, pain relievers and anti-inflammatory drugs are recommended. Short courses of hormones may also be prescribed. In case of bacterial damage, the use of antibiotics is indicated to stop the development of the infectious process. If the cause of the development of the pathology is the herpes virus, it is mandatory to take antiviral agents.

From the second week, massage procedures are prescribed, physiotherapy exercises with gradually increasing loads, which contributes to the rapid restoration of muscle tone and prevents chronicity states. Also, the affected muscles are fixed with adhesive plaster, paraffin applications are used. During this period, anticholinesterase drugs are prescribed.

After 3 months, if it was not possible to restore muscle mobility completely, biostimulants are prescribed. Reflexology and massage procedures will also be effective. In addition, eye care is required from the affected side.

For this purpose, it is recommended:

• instill artificial tear preparations or saline solution every 2 hours;
• wear glasses during the day;
• wear a wet eye patch;
• use a special eye ointment before going to bed.

When the acute period passes, physiotherapy procedures are prescribed for a speedy recovery.

Most often used:

• electrical stimulation of facial muscles - electric current therapy;
• the electrophoresis procedure, which consists in the local introduction of medications through the skin under the influence of an electric current;
• magnetotherapy to eliminate edema and reduce the inflammatory process, normalize metabolic processes;
• laser treatment to relieve inflammation, reduce pain, activate blood flow in the affected area;
• acupuncture to relieve pain and improve blood circulation. During the procedure, biologically active points are affected by thin needles;
• massage treatments.

In some cases, neuritis of the facial nerve cannot be cured with medication. If conservative methods are ineffective, surgical treatment is prescribed. It can be:

• dynamic - during the operation, synchronous movements of facial muscles on the injured and healthy sides of the face are restored;
• static - in this case, only external signs of damage are removed.

If after a while there is a relapse of the disease, in order to prevent this in the future, therapy is carried out for the underlying disease that provoked the inflammatory process.

Pills

Treatment of neuritis of the facial nerve (drugs are selected depending on the cause of the disease) can be carried out using the means of various groups. In the course of therapy, it is important to observe the exact dosage of the prescribed drugs. Overdose can cause muscle overexcitation, which provokes the onset of synkinesis. Improvement is observed in 4-6 weeks, but full recovery will take at least six months.

Drugs used in the treatment of neuritis:

Group of drugs	Names	Action
Non-steroidal anti-inflammatory drugs	Diclofenac; Diklak; Voltaren; Ibuprofen.	Drugs in this group help to reduce inflammation, eliminate pain, remove swelling.
Steroid drugs	Prednisolone; Dexamethasone.	Such drugs are used when non-hormonal therapy does not give the desired effect. Medicines allow you to get rid of inflammation, improve the passage of nerve impulses, and prevent the development of muscle contractures. These are quite strong drugs that are used according to the situation or one-time, since as a result of such treatment, side effects and addiction can occur.
Diuretic medicines	Furosemide; Indapamide.	Used to reduce puffiness, remove intercellular fluid from muscle tissue. This helps to relieve pressure on the compressed nerve.
Antispasmodics	No-shpa; Spasmol.	Such funds are necessary to reduce muscle tension, eliminate spasms, improve the contractile activity of facial muscles, and restore facial expressions. Also, thanks to the use of drugs, the spasm of blood vessels is reduced, blood flow is activated, and metabolic processes are normalized.
Nootropic drugs	Glycine; Mildronate; Cerebrolysin.	They help to improve the conductivity of nerve fibers, relieve involuntary contractions of facial muscles, and strengthen nerve tissues.
B vitamins	Milgamma; Neurobion.	They strengthen the nervous system, help improve the functioning of neurons, and have a positive effect on interneuronal connections.
Antiviral drugs	Gerpevir; Acyclovir.	It is necessary if the disease is of an infectious nature, suppress the herpes virus.
Anticholinesterase drugs	Proserin; Alcenorm.	Needed to increase the concentration of acetylcholine in interneuronal connections. This neurotransmitter carries out neuromuscular transmission, helps to improve the functioning of the facial muscles.
Muscle relaxants of central action	Tolperisone; Calmirex; Midocalm.	Necessary if the disease has acquired a protracted course, and there is a threat of contracture of facial muscles. They have weak antispasmodic and vasodilating properties.
Anticonvulsants	Tegretol; Diphenin.	Medicines of this group relieve spasms of the facial nerve.
Antibacterial agents	Amoxiclav; Augmentin.	Drugs in this group are necessary if the disease is caused by an infection. Usually, the funds are prescribed in the form of tablets, but the best effect can be achieved with their intramuscular administration.
Sedatives	Relanium; Afobazol.	Prescribed when the patient's anxiety is high. Promotes relaxation, helps to calm down, which leads to a decrease in muscle tone.
Pain relievers	Nise; Analgin.	They help to improve the patient's condition, relieving pain.

Injections

Treatment of neuritis of the facial nerve (drugs for oral administration are not always effective) in some cases requires the use of injection techniques. For acute pain that is not relieved by taking the medication, novocaine or lidocaine blockade may be recommended.

The procedure relieves pain, vascular spasm, muscle tension, inflammation and edema. Manipulations are sometimes performed under ultrasound guidance. The duration of the procedure is 10 minutes. The analgesic effect occurs immediately and can last for about 3 weeks. Repeated treatments are usually less effective.

Also, Botox injections are sometimes prescribed to solve the problem. This remedy is usually used in cosmetology, but it was originally used to solve neurological problems.

Botulinum toxin blocks nerve impulses, preventing them from reaching the muscles, which contributes to their complete relaxation. At the same time, soreness disappears, spasm is eliminated. Correction of the condition is carried out in several stages, using the minimum dose of the agent.

Before starting therapy, it is important to make sure that there are no contraindications (problems with blood coagulation, pregnancy, acute infectious process). In addition, a few days before the procedure, you must give up alcohol, avoid excessive physical activity.

You should also stop taking certain medications, especially blood thinners. After antibiotic therapy, at least 14 days should pass, since the agents of this group are capable of weakening botox, and the treatment will be ineffective.

The dosage of the agent is selected individually, depending on the area of ​​influence. All manipulations take no more than 30 minutes.

Procedure:

1. Determine the area of ​​introduction and treat it with an antiseptic. It is possible to carry out local anesthesia if necessary.
2. The bioelectrical activity of muscles is estimated using electromyography, the points of drug administration are determined.
3. Using a special syringe with a thin needle, the agent is injected, after which the skin is disinfected again.

After the procedure, the patient is left under supervision for some time in order to react in time if unexpected reactions occur. The results of manipulations with facial asymmetry are immediately noticeable: the muscles relax, soreness decreases, the patient can use facial expressions. However, slight swelling of the face may remain, which disappears in a few days. The disadvantage of this method is that it is not widespread enough and is used only in some medical institutions.

Ointments

Treatment of neuritis of the facial nerve (drugs are used both internally and externally) at home is also carried out with the help of ointments and gels. But it should be remembered that such funds help only for a short time, a complete cure is possible only with an integrated approach.

Local treatment of neuritis:

Group of drugs	Names	Action	Application
Topical non-steroidal anti-inflammatory drugs	Diclac-gel	Drugs in this group inhibit the production of substances responsible for the appearance of pain, swelling, and the production of inflammatory fluid in the affected area. They relieve pain well, reduce inflammation, eliminate edema.	Use 2-3 times a day. The amount of funds depends on the size of the affected area. The drug is applied in a thin layer and rubbed lightly. The duration of treatment is determined individually, but should not exceed 14 days. After a break of 2 weeks, the use of the drug can be resumed on the recommendation of a doctor.
Ketonal	A thin layer of cream is applied to the affected area 2-3 times a day. You can use the product for no more than 10 days. Allowed for simultaneous use with other dosage forms.
Ibuprofen	The drug is applied to the affected area with rubbing movements three times a day. The duration of therapy should not exceed 21 days.
Local irritants	Capsicam	It has a vasodilating and local irritating effect. It activates blood circulation by warming up the skin over the affected nerve. This helps to reduce discomfort.	A small amount of the product is applied to the painful area, rubbing lightly, three times a day. The duration of treatment depends on the severity of the pathological process, but does not exceed 10 days.
Combined ointments (contain NSAIDs)	Finalgon	It has anti-inflammatory, analgesic and warming properties. Contains long-acting vasodilators.	Therapy begins with minimal doses of the drug to avoid unwanted reactions. The effect can be felt within a few minutes, it is maximally manifested in half an hour. Apply the remedy 2-3 times a day.
Pain relievers	Lidocaine ointment	The drug provides an analgesic effect.	If necessary, apply to the affected area up to 4 times a day. An improvement in the condition is observed after 5 minutes. and lasts up to 1 hour.

In addition, it is necessary to use special eye ointments. Incomplete closure and dryness of the eye mucosa can cause corneal ulceration. Therefore, it is recommended to apply a special ophthalmic ointment at night and cover the eye with a bandage.

If the treatment of pathology with the help of drugs prescribed by a specialist was started on time, then improvement will occur in 4-6 weeks. In some cases, recovery from neuritis of the facial nerve does not occur earlier than after 3 months. It is important to follow all the doctor's recommendations exactly and not to self-medicate. The sooner the functions of the facial muscles are restored, the less the risk of developing unpleasant consequences.