Wrinkled Mouth or Facial Palsy (Bell’s Palsy / Facial Palsy) Is a condition in which one of the facial muscles is weak or causes temporary paralysis It is caused by abnormal facial nerves. This condition often results in the patient having half of the face crooked. Most of the patients with crooked faces are not common.
Generally Facial nerves or cranial nerves (Cranial Nerve), the seventh pair are located on each side of the face. Where each facial nerve originates from the brain Pierced through the skull and appeared under the ear Several nerves will rupture. To help support the movement of the facial muscles such as smiling, frowning or closing your eyes, as well as getting the taste from the tongue and passing it on to the brain. If the facial nerve is damaged May affect taste buds, tear production, and salivary glands. A crooked mouth is an immediate health problem. And symptoms tend to get better within a few weeks.
Dizziness will vary. Which ranged from mild numbness to the entire face paralysis Wheezing usually occurs quickly and severely within 48 hours, with the following symptoms:
- The half of the face is experiencing muscle weakness. Resulting in crooked face, unable to close the eyes, or unable to close their eyes One side of the mouth, including unable to move his face
- There may be more eye irritation such as dry or watery eyes.
- Pain may occur in the ear, below the ear, or around the jaw of the side of the face.
- Get the wrong taste Or taste less
- Auditory nerve
- The crooked side of the mouth will have saliva coming out.
- Dry mouth
- Headache and dizziness
- Tinnitus in one or both ears.
- Difficulty chewing food or drinking water
- Slurred speech
Patients who suffer from facial muscle weakness or drooling from the jawline. Should see a doctor soon. To be examined and diagnosed the severity of the illness Including receiving further treatment
Causes of a crooked lip
Cranial mouth is caused by swollen or inflamed facial nerve or 7th cranial nerve. Resulting in weak facial muscles or paralysis The cause of facial nerve dysfunction is unclear, however, the cause of facial nerve inflammation may be viral infection. Which virus that causes distorted mouth Is often infected with the following diseases
- Herpes There are two types of herpes infection that causes the facial nerve to become inflamed:
- HIV virus (HSV) Both the HIV type 1 (HSV-1) and the HIV type 2 (HSV-2) virus, the type 1 HIV virus will cause mouth sores. HIV, type 2, often causes genital herpes.
- Varicella Virus Which causes chickenpox and shingles This virus is classified as a less common cause of crooked mouth than the HSV virus.However, waricella can cause serious health problems such as hemispherical lip syndrome (Ramsay Hunt Syndrome) Yes
- Other diseases Patients infected with the virus from other diseases may also suffer from stomatitis, including cytomegalovirus. Or CMV (Cytomegalovirus: CMV) Ebstybar virus Or EBV (Epstein-Barr Virus: EBV) causes mononucleosis. (Mononucleosis)
Dizziness is a health problem that can happen to everyone, most often in people between the ages of 15-60, and 1 in 60 people can suffer from it. At a higher risk of developing mouth distortion
- Are pregnant Especially those who are very pregnant Or after delivery within 1 week
- Have diabetes
- Upper respiratory tract infections, such as the flu
- Having someone in the family suffer from distortions
- HIV infection
Diagnosis of crooked lip
There is no specific diagnosis for mouth distortion. Your doctor will check to diagnose any other cause of a wry mouth or facial hemiplegia. The doctor may examine the body. To see the movement of the facial muscles, such as closing eyes, raising eyebrows, or smiling, as well as asking the patient for symptoms. To determine if the wheezing is caused by other health problems, such as cerebrovascular disease, Lyme disease (causing bacterial infection), tumor, Moebius Syndrome, infection. In the middle ear Colestia Tomar (Cholesteatoma), a disorder caused by the accumulation of skin cells in the middle ear. Or injury to the head, however, if the cause of the mouth is not clearly found. The doctor may perform additional tests as follows:
- Blood test The doctor may take a sample of the patient’s blood for examination. To look for bacterial or viral infections inside the body
- Check muscle electrocardiogram (Electromyography: EMG) The doctor will check the muscle electrocardiogram. The electrodes, which are needle-sized, are inserted under the skin. Penetrate into the muscle Then the oscilloscope (Oscilloscope) measures electrical waves in the patient’s muscles and nerves. This test will help assess the severity of nerve damage.
- Check with scanned images The doctor may also examine the scans. Patients may have CT scans (CT Scan) or Magnetic Resonance Imaging (MRI) performed to determine the cause of the facial nerve being pressed. This is only used if the mouth is suspected due to a tumor or fracture of the skull.
Wrong Mouth Treatment
The vast majority of people with crooked mouth recuperate and heal on their own, which may not require treatment. But will take a long time to recover This can take up to 9 months. Patients need to take good care of their eyes during the recovery period. However, getting treatment will speed up recovery. The method of treating mouth crooked consists of medication, physical therapy and surgery, which are detailed below.
- Drug treatment This will help patients recover from their illness faster. The drugs used to treat crooked lips are as follows
- Steroid The steroid used to treat mouth breakouts is prednisolone. Which reduces swelling and inflammation Doctors usually prescribe this drug twice a day for 10 days, the drug should be started within 72 hours after symptoms develop. Patients may experience nausea, headache, sweating, indigestion or insomnia. Which is a side effect from drug use, however, the symptoms will get better within 2-3 days after the body has adjusted.
- Antiviral drug The doctor may give you antiviral drugs in the event that the patient’s mouth crooked from such infections. Doctors may prescribe this drug in combination with prednisolone to treat severe cases, however, in most cases, antiretroviral therapy does not improve symptoms.
In addition, patients may be given pain relievers such as ibuprofen or acetaminophen. To relieve pain that is not severe You should also take care of your own eyes in conjunction with drug treatment. To prevent dry eyes and corneal ulcers The doctor will advise patients to take care of their own eyelids as follows:
- Wear an eye mask or goggles.
- Eye drops to help keep the eyes moist.
- Apply ointments to the eyes. To prevent dry eyes at night
- Use tape to cover the upper and lower eyelids firmly during sleep.
Patients should seek immediate medical attention in the event of worsening of eye related symptoms and if the use of eye ointments and eye patch tape does not work. The doctor will perform surgery on the patient To prevent abnormalities in the eyes
- physical therapy Patients who have no improvement in their symptoms and are unable to recover after treatment. Need additional treatment The physical therapist teaches the patient to perform and massage the face. To increase the strength of such muscles To help the facial organs move in harmony As well as prevent permanent contraction of facial muscles
- Surgery The surgeon will perform the surgery. To help manage the problem of weak facial muscles This may help avoid worsening of the eye illness. Including raising the level of function and appearance of the face for the better As well as improving vision and facial features, the surgery also helps to adjust the mouth position. Adjust the symmetry of the face. Treat speech problems Eat food and drink water.Some patients may undergo nerve surgery or transplant ligaments, nerves, and muscles.However, doctors rarely operate a pinched facial nerve on a patient. Because the patient is at risk of injury to the facial nerve And permanent hearing loss
- Botox injection Crooked mouth patient Including people who have tears during eating or the wrong facial nerve. Need to get botox injections The doctor will inject botox into the crooked side of the face. In order to loosen the muscles or reduce unwanted muscle movement, your doctor will also inject botox in the face that is not skewed in case the face is affected by distorted mouth. To reduce the movement of the facial muscles and balance the two faces.
In addition, after receiving treatment Patients can take care of the symptoms of the disease by themselves as follows.
- Taking care of eyes that are not completely closed eyelids By dropping artificial tears during the day And apply eye ointments at night to keep the eyes moist Including wearing an eye mask or goggles To prevent eye lesions
- Exercise facial muscles such as tightening or loosening the face. To strengthen the muscles and encourage faster recovery from illness, the patient may also apply oil or massage cream for the forehead, cheeks and lips to help stimulate the facial muscles.
- Oral hygiene should be kept clean. Because the patient’s mouth crooked may have less saliva. Causing food to accumulate in the area And lead to gingivitis or tooth decay Patients are advised to brush their teeth and floss clean them regularly to prevent oral health problems. And chew food slowly thoroughly to prevent problems with swallowing.
- Apply a warm compress by putting a towel dampened in warm water several times a day. To relieve pain
Complications of a distorted mouth
Crooked mouth patients can have complications. Which depends on the severity of the symptoms Generally The treated patient will recover within 9 months, however, if the patient has the following characteristics: Will be at risk of complications in the long run
- All of the mouth or face paralysis occurs. Resulting in the face unable to move
- Age over 60
- There is severe pain when the mouth is crooked.
- Have diabetes
- High blood pressure
- Are pregnant
- The facial nerve is severely damaged.
- The body does not begin to recover after 2 months.
- No signs of recovery after 4 months.
In this regard, 20% of patients with distorted mouth can develop long-term complications as follows:
- Dry eyes and cornea sores Due to weak eyelids Can’t close my eyes Resulting in dry corneas and ulcers And can go blind if not treated
- 20-30% of patients with crooked mouth may have a permanent face.
- Have speech problems Which is the result of damage to the facial nerve
- Facial nerve connections are wrong. (Synkinesias) due to the abnormal growth of the facial nerve. As a result, patients often blink their eyes when eating, laughing or smiling. Some patients may close their eyes when eating. Which is considered a serious case
- Facial muscles contracting Deforming the face, such as the eyes becoming smaller than usual Cheeks are too big Or a deeper groove between the base of the nose and the mouth
- Loss of taste Or taste less Due to nerve damage
- Tears flow while eating
- Crooked mouth patient infected with Varicella virus A half-hemiplegic mouth (Ramsay Hunt Syndrome) is considered a very rare and serious condition. Patients will have clear blisters on the tongue and inside the ears. Which can be treated with steroid drugs and antibiotics
Preventing the mouth crooked
Crooked mouth is a health problem that most can take care of, however, there are no clear ways to prevent mouth crooked. Due to inflammation of the facial nerve that is the cause of this disease Will happen suddenly Make it impossible to prevent