What disease causes sudden facial asymmetry?

An 11-year-old boy was brought to the hospital by his family because of a sudden change in his mouth and stiff facial muscles.

Suddenly I couldn't smile, and I couldn't close my eyes.

According to the Department of Traditional Medicine and Rehabilitation at the Central Hospital for Tropical Diseases ( Hanoi ), doctors recently received an 11-year-old patient from Hanoi who was brought in by her family because she suddenly had a crooked mouth, stiff facial muscles, couldn't smile, and her left eye couldn't close completely. Doctors diagnosed her with peripheral facial nerve paralysis (cranial nerve VII) due to exposure to cold. After a week of treatment with medication combined with physical therapy and rehabilitation, her facial muscle movement improved significantly. According to the patient, before being admitted to the hospital, while going to school, she took off her jacket and wore only a thin shirt all day in the extremely cold weather.

Patients with facial nerve paralysis (cranial nerve VII) need accurate diagnosis and early treatment.

PHOTO: THANH DANG

Recently hospitalized, a 58-year-old patient from Hanoi reported that after a few days of cold weather, he developed a sore throat and swelling and pain in his left ear, and was diagnosed with otitis media at a nearby medical facility. After 3 days of treatment without improvement, he began to experience facial asymmetry, difficulty speaking, and inability to close his eyes completely. At the Central Hospital for Tropical Diseases, a CT scan of the brain ruled out cerebral vascular damage. Doctors determined that he had left peripheral facial nerve paralysis due to complications from acute otitis media, along with vocal cord paralysis. This patient had a history of hypertension for many years and several underlying conditions that weakened his immune system. After 10 days of treatment with anti-inflammatory and anti-edema medication, combined with facial muscle rehabilitation physiotherapy, his condition improved.

Another patient, an 83-year-old woman from Hanoi, experienced facial asymmetry (to the left) and an inability to close her right eye completely after having breakfast. Upon admission to the hospital, she was diagnosed with right peripheral facial nerve paralysis (cranial nerve VII).

WHAT IS THE FUNCTION OF THE 7TH NERVE ?

According to Dr. Le Nguyen Long, Head of the Traditional Medicine and Rehabilitation Department at the Central Tropical Diseases Hospital, cranial nerve VII controls facial muscle movement and participates in the transmission of taste, tear secretion, and saliva production. Because it passes through a narrow bony canal in the temporal bone, this nerve is very sensitive and prone to edema. When the head, face, and neck area are suddenly exposed to cold, blood vessels constrict, causing ischemia, triggering an inflammatory response, leading to edema and nerve compression, disrupting the transmission of impulses to the facial muscles.

Patients often experience symptoms rapidly, possibly upon waking in the morning, including a crooked mouth, a distorted smile, difficulty speaking, drooling or tearing on the affected side, inability to close the eye completely, and a dull pain behind the ear. These symptoms develop over a few hours to 1-2 days but do not cause any disturbance of consciousness.

DIFFERENTIATING FROM STROKE

Dr. Le Nguyen Long noted: Facial paralysis caused by facial nerve paralysis (cranial nerve VII) is quite similar to stroke, leading to confusion and delayed hospitalization or incorrect treatment. Therefore, it is important to note that facial paralysis due to cold exposure is usually not accompanied by weakness in the limbs, numbness on one side of the body, or speech disorders like stroke.

The golden time for treating peripheral facial nerve paralysis is the first 72 hours, aiming to reduce edema and increase the chances of complete recovery of facial muscle function.

To prevent facial nerve paralysis (cranial nerve VII), Dr. Long advises people to keep their head, face, and neck warm when going out in cold weather; avoid having fans or air conditioners blowing directly on their faces, especially while sleeping; and avoid showering late at night or suddenly pouring cold or hot water on their heads and faces.

When symptoms such as a drooping mouth, facial asymmetry, or inability to close the eyes completely appear, it is necessary to go to a specialized medical facility for examination, to rule out stroke, and to receive timely treatment.

Patients also need to protect the affected eye with artificial tears and a sleeping mask to prevent corneal damage; combine medication with traditional medicine methods such as acupuncture, massage, physical therapy, and facial muscle exercises. Do not self-treat with unproven folk remedies at home.

Cold weather also creates favorable conditions for viruses, especially herpes simplex type 1 (HSV-1), to reactivate. This virus remains latent in the facial nerve ganglia of many healthy individuals. When reactivated, the inflammatory immune response intensifies, leading to more severe nerve edema and causing sudden onset of facial paralysis. Patients need to be examined, diagnosed, and treated correctly, according to the Central Hospital for Tropical Diseases.

Source: https://thanhnien.vn/dot-ngot-meo-mieng-la-benh-gi-185260126190227749.htm