Treatment of neuritis of the facial nerve using acupressure facial massage, exercise therapy, biofeedback and other therapeutic techniques. Therapeutic adhesive mask Plaster for the treatment of neuritis of the facial nerve

Neuritis of the facial nerve is clinically manifested by asymmetry of the facial muscles (due to paresis or paralysis of facial muscles), the paretic side becomes flabby, sluggish, blinking of the eyelids is impaired, the eye does not close completely, the nasolabial fold on the affected side is smoothed, the corner of the mouth is lowered and pulled to the healthy side , lip movements on the affected side are absent, speech becomes slurred, the patient cannot wrinkle his forehead or frown, loss of taste, lacrimation and involuntary biting of the cheek on the affected side are noted. With neuritis of the facial nerve, complications develop: contractures in the paralyzed muscles (due to which the nasolabial fold on the affected side deepens and the palpebral fissure narrows), conjugal movements (syncinesis) - involuntary retraction of the corner of the mouth when trying to close the eye on the same side or, conversely, involuntary closing of the eye when raising the corner of the mouth. Depending on the depth of the lesion, neuritis of the facial nerve lasts from 2 weeks to several months and does not always end with complete recovery.

Rice. 47. Treatment by position: stretching the muscles of the left (healthy) half of the face and the right orbicularis muscle with an adhesive plaster

Treatment of neuritis of the facial nerve is complex: treatment by position - applying an adhesive bandage to the face (Fig. 47), early prescription of therapeutic physical training, training in voluntary muscle relaxation, differentiated and, if possible, isolated tension of individual muscles, voluntary facial contraction of two or more muscles, massage and self-massage, physiotherapy, drug treatment.

Therapeutic gymnastics for neuritis of the facial nerve is based on the general principles of therapeutic physical culture and is aimed at the fastest recovery and compensation of facial movement disorders. Contraction of the muscles of the healthy side of the face leads to constant stretching and further weakening of the paretic muscles, so it is necessary to fix the muscles of the healthy side with an adhesive bandage and pull them towards the paretic muscles. It makes chewing food easier, prevents fluid from leaking out of the mouth and improves speech. An adhesive plaster mask is applied for 1.5 hours in the first month and for 3.5-5 hours thereafter, 3-4 times a day. In the intervals between applying an adhesive plaster mask, therapeutic exercises are performed (in front of a mirror), massage and physiotherapy (by cathoding the nerve exit site, sollux, diathermy and other procedures that help improve tissue nutrition and increase the conductivity of the affected nerve). For neuritis of the facial nerve, the following active exercises are recommended: raising, lowering, bringing together, spreading the eyebrows, inflating the cheek without resistance and with pressure on it, closing and opening the eye, folding the lips, as if whistling, and blowing air, sticking out the tongue and rotating it between lips and the affected cheek, baring of teeth, pushing the lower jaw forward, shifting it towards the paretic muscles, etc. When performing active movements, you should help with a finger on the affected side (pull up the eyelid, corner of the mouth, etc.). Special exercises are carried out against the background of general developmental and breathing exercises.

To combat facial asymmetry, it is recommended to sleep on the side of the affected side; chew food on both sides, sit for 10-15 minutes several times a day, bowing your head towards the affected side, supporting it with your hand resting on your elbow; pull the muscles from the healthy side to the affected side - from bottom to top - using a scarf, pronounce the sounds O, I, A, P, F, R, V, Ш, Ж, sing.

Many people in the summer, when the weather is hot, try to find salvation from it, try to expose their heads to a pleasant, refreshing breeze. This is especially true when traveling by car, bus, or motor boat.

However, I am sure that not everyone thinks about the dangers of such pleasure. In some, this hypothermia of the head caused by windy procedures causes facial neuritis.

What does this situation mean for the health of the body, what is the danger of the disease, what are the ways to treat it, let’s figure it out together.

Facial nerve damage

Facial neuritis, occurs, as a rule, due to prolonged, sharp hypothermia of the facial skin, as well as subcutaneous tissue.

However, sometimes the reasons can be completely different, for example, damage to the temporal bone,. In addition, during a hypertensive crisis, nerve swelling may occur.

Don’t forget about a brain tumor, which can similarly, “easily” provoke the appearance of neuritis.

Typical symptoms for this disease are as follows:

- Face the patient is twisted, the eye on the affected side does not close

There is intense lacrimation, the eyebrow is lowered

On the affected side of the face, sagging skin is observed. When talking, the cheek swells greatly. Due to loss of muscle tone, the patient is able to bite his cheek while eating.

Inflammation of the mucous membrane leads to swelling and compression of the nerve, which stops sending impulses. As a result, control over the facial muscles is lost.

Treatment of neuritis of the facial nerve

To accurately identify the degree, a number of clinical studies are carried out as prescribed by a neurologist, for example, electroneuromyography, computer tomography of the brain and nuclear magnetic resonance imaging.

The therapeutic process cannot be carried out at home, since it is problematic to comply with the necessary requirements. A mandatory hospital stay is strongly recommended.

While in the hospital, the victim is given a course of specialized applications to “tighten” the facial muscles. Under the supervision of a doctor, the patient performs systematic facial gymnastics.

With minimal damage to the facial nerve, the disease can last for several weeks. A severe form of the disease usually indicates the presence of a brain tumor. Unfortunately, in such situations, facial asymmetry has a strong chance of remaining for many years.

Once you have been ill, you need to pay utmost attention to your health. Do not make “friends” with drafts, avoid facial hypothermia, during cold weather be sure to wear a warm hat, because sometimes the disease returns again.

If this does happen, then you should immediately contact a neurologist in order to promptly identify the onset of a dangerous complication called facial contracture.

With it, the muscle fibers of the affected part are strongly compressed, and the untouched half looks swollen.

Specialized massage, especially vibration, is extremely effective; acupuncture is often used.

It is worth noting that any traditional medicine recipes are used as an auxiliary treatment, in conjunction with the main medication, exclusively in consultation with a neurologist.

Facial gymnastic exercises help to quickly eliminate facial movement disorders. Constant contractile movements of the facial muscles on the healthy side entail stretching, and, consequently, a significant weakening of the paralyzed muscles.

Considering this, fixation of healthy facial muscles is required. Thanks to this action, chewing food becomes much easier for the patient, the flow of fluid from the oral cavity is slowed down, and speech is slightly normalized.

– Raising and lowering eyebrows.

– Try to bring your eyebrows together to the bridge of your nose, that is, frown, and then part them again.

Damage to the facial nerve (VII pair of cranial nerves) is usually referred to as “neuritis.” Neuritis of the facial nerve is caused by various causes; it manifests itself as peripheral paresis or paralysis of the facial muscles of the corresponding half of the face and is accompanied by its asymmetry.

Contracture of facial muscles, the most common complication of neuritis of the facial nerve, is characterized by pathological synkinesis, persistent tension of paretic muscles and clonic-tonic or tic spasms in individual muscle groups.

The most common types of synkinesis found in clinics are:

eyelid-frontal-labial - when closing the eyes, the forehead wrinkles and the corner of the mouth rises;

eyelid-plethysmic - closing the eyes leads to contraction of the subcutaneous muscle of the neck;

eyelid-nasal, or Hue's synkinesis, - raising the wing of the nose upward and outward when closing the eyes;

eyelid-ear - closing the eyes is accompanied by raising the auricle;

labio-digital - narrowing of the palpebral fissure with swelling of the cheeks;

frontolabial - raising the corner of the mouth when wrinkling the forehead.

Objectives of exercise therapy: improve blood supply to the face, especially on the affected side, as well as the neck and collar area; restore impaired function of facial muscles, prevent the development of contractures and friendly movements; restore correct pronunciation.

In the early period of the disease (days 1-10), complex treatment uses position correction, massage and LH.

sleep on your side (affected side);

sit for 10-15 minutes 3-4 times a day with your head tilted towards the affected side, supporting it with the back of your hand (resting on your elbow); tie a scarf, pulling the muscles from the healthy side towards the affected side (from bottom to top) and at the same time trying to restore the symmetry of the face;

To eliminate facial asymmetry, apply adhesive plaster tension from the healthy side to the affected side. It should be directed against the pull of the muscles of the healthy side by firmly fixing the other end of the patch to a special helmet-mask, made individually for each patient.

Exercises for facial muscles

Correction and hypercorrection of the muscles of the healthy side are carried out with a certain force, so that the antagonist muscles of the paretic side are sufficiently free in their actions and do not experience the pull of the muscles of the healthy side. The fixation of the free end of the patch to the helmet must be rigid, otherwise healthy muscles will not be kept in a state of correction. Attaching the free end of the patch directly to the skin of the affected side is ineffective: in this case, healthy muscles will immediately go beyond the control of traction and pull the skin and underlying muscles in their direction, returning facial asymmetry. It is necessary to monitor the areas of skin to which the patch is attached, preventing irritation with the help of massage and nourishing cream after the position correction procedure.

To reduce the palpebral fissure (lagophthalmos), one or two narrow strips of adhesive tape are attached to the skin of the eyelid in the middle of the palpebral fissure and gently pulled outward upward, attaching the free end to a stationary helmet. The tension force can be easily determined by the appearance of double vision in binocular vision. However, the narrower the palpebral fissure is when stretched, the easier it closes during involuntary blinking; the eye is moistened with tears, protecting the cornea from drying out.

On the first day, adhesive plaster tension is carried out in fractions - 2-3 times for 30-60 minutes, mainly during active facial actions, then the treatment time is increased to 2-3 hours a day.

Massage helps restore blood and lymph circulation, improves muscle excitability and creates the readiness of neuromuscular formations to perceive volitional impulses. To a certain extent, massage reduces muscle tone when contractures begin or increases the tone of paretic muscles. Methodically correct massage in combination with physical exercise helps reduce swelling of the facial nerve. Before each massage procedure, the patient must do a simple set of general tonic gymnastics, bending and turning the head; only after this is it advisable to begin the massage. It is recommended to start the massage procedure from the collar area, the back of the head, including the area of ​​the mastoid process and neck, preparing the main vessels of the neck to more freely receive lymph from the face and head. The direction of the massage movements should correspond to the direction of the lymph flow; they are carried out mainly along the sternocleidomastoid muscle from top to bottom. After such preparation, begin facial massage. In the first week, massage of paretic muscles is superficial, limited to light stroking. The main attention is paid to massage the healthy side of the face in order to relax the muscles, thereby reducing the overstretching of paretic muscles to the healthy side. Impact on bony protrusions - mastoid processes, orbital edges, upper jaw, chin - helps to increase the volume of facial movements. In addition to general tonics, special exercises are included in LG classes.

The main attention is paid to the muscles of the healthy side:

dosed tension and relaxation of individual muscles (zygomatic, laughter muscles, etc.) and entire muscle groups (zygomatic, buccal and orbicularis oculi muscles);

isolated tension and relaxation of those muscle groups that provide certain facial expressions (smile, laughter, attention, sadness, etc.) or are actively involved in the articulation of certain labial sounds (for example, “p”, “b”, “m”, “f” , “u”, “o”, etc.) to minimally noticeable muscle tension, especially in the muscles surrounding the oral cavity.

LH classes last 10-12 minutes twice a day. In the main period (from the 10-12th day from the onset of the disease to 2-3 months), as a rule, spontaneous restoration of muscle function begins. Active treatment is carried out with special exercises. The duration of correction increases to 4-6 hours per day; it is alternated with exercise classes and massage. Gradually increase the tension of the adhesive tape, achieving hypercorrection with a significant displacement to the affected side in order to achieve stretching and thereby weakening of healthy muscles. The massage is carried out with light and deeper stroking, rubbing, and vibration at the points (acupressure techniques).

Most massage techniques are acupressure, so that the displacement of the skin is insignificant and does not stretch the skin of the weakened half of the face. The main massage is carried out from inside the mouth, it performs the functions of reduction (muscle designation) and massage, enhancing blood circulation, trophic processes in paretic tissues, etc. All measures to correct facial movements must be carried out with the active participation of the patient. To do this, the methodologist explains and demonstrates techniques in front of a mirror, cultivating in the patient the ability to control voluntary movements.

The following help significantly in mastering missing movements:

preliminary relaxation of the muscles with light massage movements and performing individual exercises: - simultaneous and alternate puffing of the cheeks;

snorting, pronouncing the sound “p” with a preliminary active delay at the initial phase of movement;

the indication (pointing movement) carried out by the methodologist is a short stroke stroking the skin of the face in the area of ​​paretic muscles. The direction of the indication corresponds to the facial movement. This technique gives the patient an idea of ​​the direction of movement and helps to implement it;

manual assistance when performing movements - this assistance from a methodologist is necessary to perform complex facial movements, for example, when closing the eyes, wrinkling the forehead, smiling, etc.

The methodologist models the facial act, corrects its execution, eliminates unnecessary movements, and then helps weakened muscles to engage in work;

resistance to the main movement provided by the methodologist to increase the strength of paretic muscles - K. Lewit’s method, “post-isometric muscle relaxation” (PIRM): preliminary stretching of the facial muscle, dosed resistance with the hands of the methodologist and manual retention of the performed movement (isometric tension) followed by muscle relaxation .

In the residual period (after 3 months), all means of exercise therapy that were used in the main period are used. Rehabilitation therapy is aimed at training weakened muscles, eliminating the imbalance of antagonist muscles, improving afferentation, restoring the old and creating a new optimal stereotype of muscle relationships. Along with this, stereotypical facial acts are developed within the limits of satisfactory self-correction (smile, attention, surprise, etc.). During this period, paresis of the facial muscles is often accompanied by contracture of the corresponding muscles, which increases facial asymmetry and contributes to the occurrence of synkinesis. To overcome muscle contractures, the patient is recommended (first with the help of a methodologist, and then independently) to systematically carry out stretching movements with the first fingers along the muscle fibers, gradually, from session to session, increasing the applied force.

Methodological features of stretching facial muscles: muscle stretching is carried out from the center of the muscle to the periphery; Stretching the circular muscles is performed with successive movements, alternating fingers along the muscle fibers. In PH exercises, two types of stretching movements are most often used:

the movements of the fingers are directed in opposite directions, they simultaneously stretch a small area of ​​the muscle; then the hands are moved to the adjacent area. This procedure is repeated along the entire length of the muscle;

one of the fingers fixes the muscles to the underlying tissues or bone, the other stretches the muscle in a small area along the fibers; then a similar movement is repeated on the adjacent muscle section.

Both types of movements complement each other. It is usually recommended that after simultaneous muscle stretching (type 1), stretching with sliding fixation (type 2) is performed.

For better stretching of contracted muscles, along with finger movements along the course of muscle fibers, stretching across their course is used.

The muscles located in the thickness of the cheek are accessible for stretching from the mucous membrane. The methodologist inserts the index finger into the patient’s mouth and creates support for stretching the contracted muscle with the hand located outside. After stretching, the muscles are better involved in voluntary motor acts. To consolidate the results of treatment measures, the patient is given an adhesive bandage (positional correction).

Synkinesis distorts the physiological functioning of the facial muscles, prevents the patient from fully and efficiently performing a given movement, and sometimes makes it impossible to contract a certain muscle. Good results are achieved by a relaxing massage of additionally contracting muscles. In some cases, point pressure on the muscles that perform synkinesis is effective; in combination with tensing the arm muscles or clenching the teeth, the required movement can be performed. It is necessary to fix the patient's attention on this. Then they achieve voluntary execution of a friendly movement, after which synkinesis is gradually eliminated.

Original article www.eurolab.ua Illustrations from the site: © 2011 Thinkstock.

Almost from the very first days from the onset of the disease, it is recommended to use exercise therapy for neuritis of the facial nerve. In this case, the treatment complex includes massage, exercises, procedures using medical equipment to warm up the facial muscles, as well as simply strengthening gymnastics.

All treatment can be divided into periods:

• elementary;
• basic;
• residual phenomena.

It may occur due to a previous illness, unsuccessful surgery, or nervous shock. To help the patient cope with the disease, in the first days after the onset of the disease, a technique is used that fixes the paralyzed part of the face in the most natural position. For this purpose, a special frame is made for each specific patient.

It is fixed on the head and face with an adhesive plaster, resulting in a kind of splint, similar to those previously used for fractures and severe bruises.

The mask is not worn constantly, it needs to be done every day as part of massage sessions, an active period for facial expressions (during communication, eating).

The treatment mask is used for 10 days during the day, and at night, taping is done on its basis to create a palpebral fissure. This method of exercise therapy for neuritis of the facial nerve has a dual purpose: keeping the facial muscles in the desired position, protecting the cornea of ​​the eye so that the resulting defect does not damage it. That is why when creating a palpebral fissure, they strive to make it as small as possible.

When applying the mask correctly:

• the fixation is quite strong, double if necessary;
• the fastening force does not create discomfort for the healthy side;
• the muscles of the affected side have freedom of movement;
• Particular attention is paid to strengthening the eye muscles.

Since taping is done using an adhesive plaster, after removing the corset, the skin at the attachment points is lubricated with cream.

For those who cannot afford to create a mask, it is recommended to perform the following exercise:

• relax the facial muscles on the healthy side;
• place one palm on the healthy side closer to the ear;
• the second with the back side closer to the chin of the affected side;
• then the facial muscles seem to be pulled with the hands from the healthy one to the affected one.

• sit on the edge of a chair;
• hang your head down and to the side of the lesion;
• Place your elbows on your knees and support the painful part of your face.

But this is not yet therapeutic exercises for neuritis of the facial nerve, it is simply a manipulation, identical in importance to gargling for a sore throat.

Initial period: exercises

The danger of this period is that the affected areas of the face constrain healthy muscles and reduce their use. Ultimately, this can lead to muscle atrophy.

Therapeutic gymnastics in the initial period is aimed at:

• maintaining the activity of the uninjured party;
• passive exercises for the affected part of the face.

The basic principles of physical therapy are to encourage the movement of damaged muscles as the patient feels better.

There is practically no place for physical education in the literal sense of the word; the patient must try to tense the facial muscles, try to smile and articulate, pronouncing both individual vowel sounds and consonants. This will allow the facial muscles in the mouth area to move equally on both sides.

Such exercises for neuritis of the facial nerve are performed for up to two weeks and take 10-15 minutes in the morning and evening. It is clear that they are the basis for physical education during the main recovery period.

Physical tension of the facial muscles can be supplemented with self-massage of the face. It can be made for eyelids. To do this, just close your eyes, place your finger on your eyeballs and stroke them for 30 seconds in a clockwise circular motion.

You can massage the nostrils of the nose by stroking both parts of the face: the healthy part with downward movements, and the affected part with upward movements.

Something similar is done with the midline of the eyebrows. Using circular movements, pull the sore muscle up and the healthy muscle down.

After a two-week period, following all the described recommendations, the patient should be ready for more serious exercises.

What to do during the main period of treatment

During the second period of treatment, the mask is continued to be made, first increasing the time and frequency of wearing. As improvement occurs, this procedure is reduced to a minimum, eventually abandoning it.

The main treatment period can last 2-3 months.

Physical education in this case consists of training the expression of emotions; for this, the following simple exercises are used:

• raised/lowered eyebrows;
• look gloomy;
• smile without opening your mouth;
• look into the distance.

Any facial muscle actions associated with manifestations of human feelings are suitable. But there are also exercises that go beyond just emotions. They are more like speech therapy, when you need to open your mouth, stretch your tongue forward, roll it into a tube, and make a frenulum. Again, any action that will not strain the patient and cause severe physical and mental fatigue is useful.

With the advent of improvements, facial gymnastics become more complicated, alternating two or more types of facial techniques.

In addition to gymnastics for the facial muscles, exercise therapy during this period includes the following exercises for the eyes:

• follow the object;
• smoothly move your gaze from right to left and vice versa, without turning your head;
• use your cheeks: inflate, push air, as when rinsing;
• vibrate your lips.

In order not to overwork the patient with physical activity, which is also complicated by mental stress, classes should be kept moderately long and the patient should be allowed to rest. If the lesson lasts an hour, then no more than half of the time can be spent on completing tasks.

Elements of habitual gymnastics also need to be diluted with activities aimed at restoring speech. To the exercises completed in the initial period, another dose of tasks is added: first you need to pronounce combinations of sounds, and then gradually begin to pronounce words. At the same time, they place a clear emphasis on the separate pronunciation of words, gradually complicating their structure from “ma-ma my-la” to “kosh-ka on o-kosh-ke”.

If physical education lessons begin with warming up the muscles, then exercises for the facial muscles begin with relaxing them. And this should be the rule at all stages of recovery.

Elimination of residual effects

All the measures taken will definitely bring at least some result, but it will not always be the most acceptable. Even if you try to come to terms with an asymmetrical defect, speech difficulties remain that must be eliminated.

At this stage, there is no need to make a fixing mask - solely at the request of the patient himself. But it is necessary to continue all facial exercises, vision exercises, and also perform speech techniques. You can complement the gymnastics by tilting your head down and shaking it to the sides, as if dispersing the muscle mass throughout the face. According to the doctor’s recommendations, you can undergo a course of physiotherapy in an exercise therapy room, where the facial nerve is warmed up.

During this period of time, it is advisable to conduct classes in front of a mirror. Their goal is simple: if it is not possible to achieve facial symmetry, it is necessary to hold the healthy side, stimulating the work of the second, and at the same time achieving an acceptable facial expression that will not frighten either the patient or his relatives. Over time, this defect will go away.

Among other things, you can use exercises that are recommended for cervical osteochondrosis: turning the head to the sides, tilting it towards the shoulders, forward. This will allow the unaffected facial muscles to remain in vital tone, and the affected ones will at least provide pain relief.

It is common, there are reasons for this: the nerve lies in a narrow place (the ear canal), swelling compresses it.

The disease is expressed in lacrimation, drooping of the corner of the mouth, and sloping of the face to one side.

The disease is successfully treated, and exercise therapy for neuritis of the facial nerve plays an important role.

Exercise therapy is prescribed by neurologists from the 1st day of illness; it cannot be stopped after recovery.

The disease imposes restrictions on lifestyle:

• do not overcool;
• speak little and quietly;
• eat in small portions, chew on both sides.

There are general rules for conducting therapeutic physical training for neuritis of the facial nerve:

• exercises are done in front of a mirror;
• each time those muscles that produce a certain movement must be involved. For example, when smiling you should not frown;
• You can first do the exercise mentally, then in practice.

The herpes virus is a common cause of damage to the facial nerve. It is necessary to treat herpes and other infections, as well as otitis (including non-infectious), caries, mumps.

Physiotherapy

Exercise therapy includes gymnastics and hardware procedures.

Table. Stages of exercise therapy

In the basic period, a corset is worn on the face.

If you couldn’t buy a corset, you need to do the following exercises:

1. place your palm closer to the ear of the healthy half, the 2nd hand on the chin towards the affected part;
2. pull your arms in the direction of paralysis, restoring symmetry;
3. sitting on the edge of a chair, lower your head in the direction opposite to the lesion;
4. leaning your elbow on your knee, hold your head on the painful side.

Perform 3-4 times a day for 15 minutes.

You can replace the corset with positional treatment; this does not replace exercise therapy, which includes:

1. massage the closed eyelids with the index finger in a clockwise circular motion;
2. stroking the eyebrows from the middle, the diseased half of the nose up, the healthy half down.

When changing a corset, you need to lubricate your face with cream.

Mainly period e Exercise therapy begins with working out the shoulder girdle. While sitting, you can move your hand to the side and fixate it with your gaze; rotate the shoulder joint with the hand attached to it in different directions; raise and lower your hands. The patient does not get tired of these exercises.

Acupressure is carried out in acute forms of the disease with the index finger, the blunt part of a pencil, and a toothpick on certain areas in a clockwise direction for up to 4 minutes, until warmth and numbness are felt.

Places for acupressure massage are:

• muscle tubercle on the back of the hand with the thumb adducted;
• from the outside at the end of the fold of the elbow joint when it is bent;
• the canine fossa will be revealed when you place your index finger under the cheekbone with your mouth slightly open;
• cartilage right under the nose, at the beginning of the nasal fold.

Vacuum needle therapy and treatment with the Darsonval apparatus are done at home and in the hospital.

When performing exercise therapy exercises for neuritis of the facial nerve, one should not allow the face to skew to the healthy side.

Treatment by position

Positional treatment involves applying an adhesive plaster, which is attached to a custom-made helmet, from the healthy side of the face to the diseased side.

Active gymnastics techniques for facial neuritis

To reduce the palpebral fissure, 2 strips in the middle of the eyelids are pulled until double vision is achieved and brought outward and upward. In other cases, such treatment should be carried out during the day. Perform for 30-60 minutes 2-3 times a day, gradually increasing to 3 hours, when eating, talking, performing household activities.

Apply eye strips at night to moisturize them.

Special exercises for facial muscles

This exercise therapy is carried out during the main period. It is necessary to hold healthy muscles with your hand so that they are relaxed, and correct them on the affected part of the face so that they “look” healthy. It is important to achieve symmetry.

Approximate sequence of exercises:

1. frown and raise eyebrows;
2. look at the tip of the nose;
3. adopt an angry expression, then “put on a mask” of surprise and grief;
4. smile with your mouth closed and open;
5. bare teeth;
6. blow;
7. whistle;
8. put out the candle;
9. grab the lower lip with your upper teeth, then the upper lip with your lower teeth;
10. look down without using your head, close your eyes, “helping” the eyelid on the affected side with your finger, wait 1 minute; open eyes; repeat 2 more times;
11. close your eyes;
12. open your eyes wide;
13. squint;
14. alternately close your eyes;
15. follow with your eyes the finger moving clockwise and counterclockwise;
16. blink at different paces for up to 6 seconds;
17. pronounce the sound that stops the horse - “whoa-u”;
18. snort up to 5 times or whistle for up to 4 seconds - while exhaling;
19. widen the nostrils;
20. interfere with the flow of air when inhaling with your fingers, placing them on the wings of the nose;
21. inflate and retract your cheeks, then alternately one and then the other;
22. rinse your mouth;
23. “clean” your teeth with your tongue, move it across the roof of your mouth - without opening your mouth;
24. swing your tongue left and right, back and forth, make circles clockwise and counterclockwise - with your mouth open;
25. stick out your tongue, pointing the tip;
26. clatter;
27. roll the edges of the tongue towards the center.

Repeat 6 times, then increase to 20.

To restore a smile, it is enough to make the patient laugh by warning him about it.

Exercises to improve articulation

At the main stage, when forming syllables, vowel sounds must be combined with consonants, and be sure to include b-p, v-f, m, since their pronunciation uses the facial muscles to the maximum.

For each pair of letters we form “direct” and “reverse” syllables, for example, “fi-if”, “mo-ohm”. It is necessary to pronounce the syllables clearly, like an actor, using your lips.

As the condition improves, the patient should read fairy tales in front of the mirror, making sure that the face does not distort.

Period of residual effects

Sometimes the consequences of neuritis do not go away completely due to incomplete passage of the nerve impulse. Then you need to continue the exercises of the main stage with the addition of bending and shaking your head from side to side.

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Video on the topic

Healing techniques of exercise therapy for neuritis of the facial nerve in the video below:

Our health directly affects our smile. Even without medications, exercise therapy gives good results. It all depends on the diligence of the patient.