Facial Nerve Problems (cont.)
What are treatment options of facial nerve paralysis?
Underlying medical conditions which lead to facial nerve disorder are treated
specifically according to the condition detected. Cortisone medications
(corticosteroids) are the best treatment for Bell's palsy, and it is recommended
that all patients be treated. The usually amount is one milligram per kilogram
body weight of prednisone (or steroid alternative)
per day. Recently, antiviral medications like acyclovir
(Zovirax) given in a dose of 200-400 milligrams five times per
day for five days have been demonstrated to increase recovery. After five days
of treatment, if the paralysis improves, the acyclovir is stopped and the
steroids can be tapered (gradually discontinued) over the next five days. If the
paralysis is still complete after five days, then the same dose of both
medications are continued for another five days, then the steroids are tapered
over the next five days.
Physical therapy and
electrotherapy probably have no significant benefit. Surgical facial nerve
decompression is controversial in Bell's palsy. Some
physicians recommend surgical decompression during the first two weeks in
patients showing the most severe nerve degeneration.
What is the treatment for eye problems from facial nerve disorder?
Patients with facial nerve paralysis have difficulty keeping their eye closed
because the muscle which closes the eye (orbicularis oculi muscle) cannot work.
Serious complications can occur because the cornea of the eye becomes too dry.
Treatment consists of:
- Protective glasses can prevent dust from entering the eye.
- Patients can manually close the eye with a finger to keep it moist.
- Patients should use the back of their finger rather than the tip to insure
that the eye is not injured.
- Artificial tears can help to keep the eye lubricated.
- The eye can be taped or patched closed with paper tape
while asleep, and an ointment used to keep the eye lubricated.
- A temporary or permanent narrowing of the eye opening (tarsorrhaphy) may be
necessary.
Next: What surgical reconstruction options are available? »
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