Every year, it is estimated that 80,000 Brazilians live with the problem, which mainly manifests as a twisted mouth and difficulty moving the face; a specialist from Paulista Hospital emphasizes the importance of immediate medical follow-up
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Imagine waking up one beautiful day and, upon looking in the mirror, finding your face paralyzed or even disfigured? A terrible situation, no doubt – that seems like something from a movie, a soap opera. But it’s not just restricted to fiction, unfortunately.
Every year, it is estimated that about 80,000 Brazilians live this drama in real life. The recommendation, indeed, to anyone with such a problem is to go immediately to the hospital. Most of the time, these cases are reversible. But it requires swift diagnosis – as explained by Dr. José Ricardo Gurgel Testa, an otolaryngologist from Paulista Hospital who specializes in this type of care.
“Idiopathic facial paralysis, also called Bell’s palsy, is a medical emergency and should make the patient seek an emergency room for the first care as soon as possible. The timeliness of diagnosis and treatment is a crucial factor in the result of improvement or cure,” emphasizes the specialist, explaining that this type of alteration is directly associated with inflammation or swelling of the facial nerve.
“When affected for some reason, this nerve causes symptoms such as a twisted mouth, difficulty moving the face, and/or lack of expression on one side of the face, which can also significantly alter communication and people’s self-esteem,” the doctor emphasizes.
The causes, however, can have different natures: stress, low immunity, sudden temperature change, neoplastic diseases, or even idiopathic – that is, without defined causes.
Types
Dr. Testa explains that there are two main types of facial paralysis: central – that is, of the central nervous system, which are due to stroke, degenerative diseases, or tumors; and peripheral facial paralysis, which can be traumatic, infectious, congenital, tumoral, metabolic, and also idiopathic – as previously highlighted.
“Each has a specific type of treatment that must be directed by the doctor. Some patients require auxiliary examinations, such as audiometry and impedanciometry, imaging tests (computed tomography and magnetic resonance imaging), and electrophysiological tests, as well as laboratory tests, until reaching the exact diagnosis,” observes the specialist.
Most of the time, however, the diagnosis of facial paralysis is made through medical observation. “The symptom that most attracts attention is the sudden, partial or total loss of movements on one side of the face, a condition that can worsen over several consecutive days.”
The doctor also draws attention to signs such as a twisted mouth, more evident when trying to smile; inability to completely close one of the eyes, to raise one of the eyebrows, or to furrow the forehead; pain or tingling in the head or jaw; and increased sound sensitivity in one of the ears, as well as taste changes.
Treatments
According to Dr. Testa, most cases of facial paralysis are transient, and there are several possible treatments, depending on the causes. “The treatment for peripheral facial paralysis is symptomatic and includes the use of medication, physiotherapy, and speech therapy. There is no standard therapeutic conduct for the disease. It depends on each case.”
The improvement, in turn, may depend on the type and extent of damage suffered by the facial nerve, the clinical conditions, and the age of the patient. In most cases, facial paralysis tends to regress as the swelling of the nerve spontaneously decreases.
In this context, according to the doctor, physiotherapy and speech therapy are important allies to stimulate the mimicry muscles of the face and speech, as well as to prevent contractions and muscle fiber atrophy.
