The clinical manifestations of facial paralysis are mainly bilateral facial paralysis, which is characterized by inability to frown, frown, close eyes or incomplete eyes, photophobia, tears and bell phenomenon. The mouth leans to the healthier side, air leaks from the seriously ill side when the cheeks swell, and water leaks from the seriously ill side and drools when gargling. When eating, food stays between the teeth and cheeks of the seriously ill party. Unilateral facial paralysis is rare, and its clinical symptoms are similar to bilateral severe and mild facial paralysis. Traditional Chinese medicine calls it crooked mouth and crooked eyes, commonly known as hanging line wind and aiming wind (just like carpenters hanging line and soldiers aiming). For example, when bilateral peripheral facial paralysis is of the same degree, the face will be expressionless, unable to laugh, eyes will not be closed tightly, lips will not be closed tightly, food will be left on the cheeks when eating, and speech will be unclear. Traditional Chinese medicine calls it total paralysis, commonly known as vegetative paralysis and stupid paralysis. These three kinds of peripheral facial paralysis have an urgent onset, which can occur at any age when they are washed or talked with people in the morning. In particular, the severity of unilateral type and bilateral one-heavy-light type will change with each other in the development of the disease; Or the muscles on the primary side have shrunk, and the healthier side has become paralyzed. This is a common reason why quarrels are first biased to one side and then to the other. There is also chronic external stroke, which does not belong to peripheral facial paralysis. Facial muscles are not paralyzed, the mouth is not crooked, and the eyes are not oblique. It is characterized by headache, tight head, pain behind ears, neck pain, shoulder pain, back pain, lumbago, leg pain, cold hands and feet, cold back, cold half-body, tight half-body, cold face, face pain and tight face. It also belongs to the category of external stroke, which is much easier to treat than acute facial paralysis, but if it is not treated properly, it will last for many years or lead to chronic peripheral facial paralysis.
Most of the reasons are pulse deficiency and feeling cold. Followed by liver and kidney yin deficiency, wind and yang imbalance. Thirdly, the seven emotions are too extreme (joy, anger, worry, thinking, sadness, fear and shock), as well as internal capsule injury, intracranial hemorrhage, intracranial tumor, infection (such as meningitis), otogenic disease (such as otitis media), tumor (such as acoustic neuroma), trauma (such as bumps and falls), poisoning (such as alcohol) and metabolic disorder (such as alcohol). In particular, the most common causes of this disease are: picking ears, picking teeth, drinking, sweating and suddenly catching cold.
1) A common disease characterized by motor dysfunction of facial expression muscles is called facial paralysis, also known as facial paralysis. According to the different damaged parts, it can also be divided into central facial paralysis and peripheral facial paralysis.
1. Central facial paralysis: Facial paralysis caused by the lesion between the digital facial nerve nucleus and the center of the cerebral cortex, that is, when a cortical brainstem bundle is damaged, it is also called supranuclear facial paralysis.
2. Peripheral facial paralysis: refers to facial paralysis caused by facial neuromotor fiber lesions (commonly known as "crooked mouth"). Lesions can be located below the facial nucleus, such as the lower pontine, middle ear or parotid gland. All the muscles of the affected side are paralyzed, which are manifested as eyelid failure, frown, air leakage in cheeks, mouth and eyes askew, tears in eyes, etc. And may be accompanied by hearing changes, loss of taste in the first two thirds of the tongue, saliva secretion disorders and other clinical features.
2) The monitoring effect of facial paralysis surgery is better.
People must have normal facial nerves to have a variety of rich expressions to express their inner feelings. The occurrence of facial paralysis will make people's forehead lines disappear, unable or unable to lift their eyebrows and close their eyes, their mouths tilt to one side, they can't speak clearly and lose their ability to express themselves. According to reports, some facial paralysis can be recovered by drug treatment, while others need surgery. Therefore, it is of great significance to choose the correct treatment for patients with facial paralysis. Before treatment, facial nerve monitor is used to evaluate the postoperative function of facial nerve, and facial electromyography is used to judge the degree of facial nerve injury, which patients need surgery and which patients need conservative treatment. During the operation, facial nerve monitor can also be used to assist in the corresponding facial nerve surgery. Generally speaking, almost all patients with facial paralysis can be cured if they are treated regularly in the early stage.
3) How to do a good job in nursing patients with facial paralysis.
On the one hand, facial paralysis can be treated with drugs at home, on the other hand, it needs to go to the hospital for comprehensive treatment.
Take a proper rest in the acute phase, keep your face warm, wear a mask when you go out, and stay away from the window when you sleep to avoid catching cold again. When there is pharyngeal infection, antibiotics should be taken orally at the same time. Those who take prednisone should strictly follow the doctor's advice, and should not increase or decrease the dosage at will, and pay attention to observe whether there are any side effects.
In the acute stage, the affected side was externally applied with a damp and hot towel, 3-4 times a day, each time 15-20 minutes. Patients can be instructed to massage the paralyzed facial muscles in front of the mirror for 3-4 times a day, each time for 3- 10 minutes. Because this disease can't close the eyes of the affected side, you should wear an eye mask and antibiotic eye ointment when sleeping and going out to protect the cornea and prevent conjunctivitis. Rinse your mouth in time after eating, remove food residue between the affected cheeks and teeth, and keep your mouth clean. Give nutritious and digestible soft food, ban smoking and alcohol, and avoid irritating food.
4) Chinese medicine treatment
1. "Sanbai Wuchong Decoction" in addition to "facial paralysis"
Facial paralysis, also known as "facial paralysis" and "mouth-eye deviation", is a common disease in neurology. The main symptoms are sudden paralysis of facial muscles on one side, inability to close eyelids, tears, disappearance of facial expressions, unclear pronunciation, rice leakage during eating, disappearance of forehead lines, inability to frown, wrinkles on forehead, bulging cheeks, toothless whistling and shallow nasolabial groove. When the patient closes his eyes, the eyeball of the affected side turns outwards and upwards, often exposing the white sclera. Rheumatism, otitis media, brain diseases, invasion of pathogenic wind and sudden cold can all cause this disease.
Traditional Chinese medicine believes that "evil combination leads to weak qi." This disease is mostly caused by pulse deficiency and cold, which leads to obstruction of menstruation, disharmony between qi and blood, and obstruction of meridians, which leads to the loss of nourishment of meridian muscles and the onset of the disease. The author's self-made "Sanbai Wuchong Decoction" has been used to treat facial paralysis for many times. Generally, it can be cured by taking 10- 15. Patients may wish to have a try.
Medicine composition: 20g of Radix Paeoniae Alba, 0g of Radix Angelicae Dahuricae15g, 6g of Rhizoma Typhonii, 0g of Bombyx Batryticatus15g, 0g of periostracum cicadae15g, 5g of fried earthworm10g of scorpion10g, and radix Saposhnikoviae10g.
Usage: Except centipede, decoct in water twice, take it in the morning and evening, daily 1 dose. Baking centipede on tile, grinding into fine powder, and decocting twice.
The "350 Insects" featured Radix Saposhnikoviae, Radix Angelicae Dahuricae, Rhizoma Typhonii and Ramulus Uncariae cum Uncis, which can dispel wind and cold, increase tissue metabolism, reduce inflammation and edema, and promote smooth blood circulation. Use "Five Insects" (Scolopendra, Scorpio, Bombyx Batryticatus, Periostracum Cicadae and Lumbricus) to dispel wind and dredge collaterals, so as to speed up the circulation of qi and blood in meridians; Radix Paeoniae Alba and Rhizoma Chuanxiong nourish blood, promote blood circulation and dispel wind; Astragalus qi, strengthening the body resistance and expelling wind. The combination of various medicines can dispel pathogenic factors and dispel cold, nourish meridians, dredge blood vessels and treat facial paralysis.
2. In recent years, according to the pathological changes of edema around facial nerve, some doctors advocate clearing away heat and toxic materials, eliminating local edema and improving curative effect. Anyone suffering from facial neuritis accompanied by sore throat, swelling or tenderness of the mastoid behind the ear can take this prescription:
① Take honeysuckle, gypsum, Radix Isatidis, Rhizoma Phragmitis, Radix Scrophulariae 30g, Fructus Forsythiae 25g, Radix Rehmanniae, Folium Isatidis, Herba Violae 20g, Fructus Arctii 65438±05g, Herba Menthae, Radix Sophorae Tonkinensis and Radix Glycyrrhizae 65438±00g. Decoct with water twice a day. It is best to take it within 1 week of onset.
(2) recovery period and sequela period, generally refers to 2 weeks after onset, you can choose:
Radix Rehmanniae 30g, Rhizoma Chuanxiong, Radix Astragali 15g, Radix Angelicae Sinensis, Bombyx Batryticatus, Lumbricus, Radix Paeoniae Rubra 12g, Flos Carthami 10g, and Scorpio 6g. Decoct with water twice a day, each time 150ml.
③ In addition to oral administration, it can also be combined with external drugs to improve the curative effect. Acute phase visit:
A. Take 55g of Radix Astragali, 0g of mustard seed10g, Rhizoma Typhonii, Bombyx Batryticatus, Radix Saposhnikoviae, Fructus Forsythiae, Fructus Gardeniae, Semen Persicae, 6g of Scorpio and 3 centipedes.
Grinding the medicine into fine powder, and mixing with a little flour, egg white and white wine to make paste when externally applied; Bai Yang, Sun, Zheng Qian, cheekbones with safflower oil liniment? , underground warehouses, cheek carts, and wind pools are red; Or apply a hot towel to your face; Or massage the above-mentioned acupoints by hand, put about 6 grams of medicine at each acupoint on a plaster or adhesive tape with a diameter of 5 cm, and fix the medicine on the acupoints. After applying the medicine, the face feels tight, stretched and feverish, which usually lasts for 2-4 hours. Replace it once a day, with ten days as a course of treatment, with recovery as the degree. In the recovery period, 30cm tender mulberry technology, 60cm Sophora branches, 15g mugwort leaves and 15g pepper can be selected. This soup is often used to wash your face, first on the affected side and then on the healthy side. Reliable curative effect.
B. Mix and pound a proper amount of Gleditsia sinensis powder and castor bean into a lake shape. Before going to bed, the left side is obliquely attached to the right side, and the right side is obliquely attached to the left side. Use it once every night for a week. This recipe treats crooked mouth and crooked eyes.
5) Pay attention to prevention at ordinary times, keep cheerful and ensure proper sleep and rest. Avoid the cold wind at night. Once you get sick, you should pay attention to protection, wear a mask when you go out in cold weather, and wear an eye mask when your eyes are not closed properly to prevent corneal damage. Wash your face with hot water, often massage local acupoints, and carry out necessary facial expression muscle training.
Love tip: please consult the local regular Chinese medicine hospital for the above prescriptions, and select the prescriptions according to their own physiological characteristics and different pathological changes.