Contorted face from a cold. Facial asymmetry: causes of pathological disorders and methods for their correction. Distorted face: reasons

NEURITIS OF THE FACIAL NERVE(also called Bell's palsy) is a sudden unilateral paralysis of the muscles innervated by the facial nerve. Often accompanied by pain.

Why does

This form of neuritis occurs after hypothermia or against the background of some infectious disease (from influenza to rheumatism). But facial injuries can also be the cause of facial neuritis.

Symptoms

At the very beginning of the disease, when the muscles of the face are still active, pains appear behind the earlobe - on the side where you were blown away.

Dryness of the eye on the affected side may appear, or, conversely, lacrimation from it.

Sometimes dryness appears in the mouth, and a taste disorder may also develop.

Sometimes there is abnormally acute hearing or painful sensitivity to sounds. Subsequently, the face on the affected side becomes mask-like, asymmetrical when smiling or crying. The patient loses the ability to wrinkle his forehead, close his eyes on the side of the lesion. Usually in such patients one eye is wide open, the eyebrow, lower eyelid and corner of the mouth are lowered. Speech becomes slurred.

Treatment

The first thing to do is to see a doctor. Patients are prescribed anti-inflammatory drugs (Aspirin, Brufen, Ibuprofen, Metindol, Reopirin) and injections of vitamins B1 and B12. In addition, the doctor will send you to physical therapy to warm up the lesion.

1. Sleep on your side on the affected side.

2. 3-4 times a day for 10-15 minutes. sit with your head bowed to the affected side, supporting it with your hand.

3. Do a light neck massage. In the first days, massage the neck for 5-7 minutes, then gradually increase the duration of the massage to 15-20 minutes.

4. Do therapeutic exercises:

Raise and lower your eyebrows;

Puff out your cheeks, simulating mouthwash;

Close and open your eyes;

Stick out your tongue and bare your teeth.

Do the exercises daily, and in front of the mirror, 10-15 times.

Folk recipes

RASPBERRY TINCTURE

Pour 1 part of raspberry leaves (sold in a pharmacy) with 3 parts of vodka and leave for 9 days. Strain and take during the first 10 days - 20 drops 3 times a day for 30 minutes. before meals. In the next 10 days - 30 drops, and in the third decade (another 10 days) - 50 drops. Then 30 drops until the end of treatment. Course - 3 months.

STEAM BATH

You can breathe over a boiling decoction of wormwood, yarrow, laurel or peppermint. This has a relaxing effect on the muscles.

I have experienced this truth for myself. After a stroke, my face was distorted, my speech was slurred, and the right side of my body remained paralyzed for a long time.

I had two courses of injections of cerebrolysin. Cavinton, nootropil, gliatilin helped improve memory, restore speech and concentration. In addition, I took tablets of instenon, vinpocetine, piracetam, arbiflex, trental, pentoxifylline.

Every day I do gymnastics from 3-4 complexes. I pay special attention to exercises that are difficult, but necessary to perform to restore the mobility of the arm and leg. And do not think that everything will work out right away. I started with one step, with a massage of each finger to bend. It is better to choose a complex that is easier to digest and so as to resume the most vital movements. Here, for example, are exercises for the wrist joint of the hand, which Nina Ivanovna Kovalenko from Penza recommended to me:

We drum our fingers on the table. We make a “twine” with our fingers. We spread our fingers wide and bring them together. Raise and lower each finger, then the palm. Holding the sick hand with a healthy hand, we raise and lower the sore hand. Putting your elbows on the table, reach your palm with your fingers. With the thumb, press in turn on each finger of the same hand. With a click, push each other finger away from the thumb. "Figs". We clench our fingers into a fist and unclench.

Resistance exercise. Putting your palms together, we rest our fingers in turn against each other. Leaning with the elbows of the hands on the table and joining the palms together, we bend and unbend the hands towards ourselves, away from us and in both directions. Keeping your palms together, slide your elbows out to the sides on the table. We massage each hand with the other hand from the fingertips to the elbow.

We roll the rolling pin on the table with the palm of our hand. We turn the stick left and right. We twist the foam rubber with our fingers. Holding the stick in your hand, we bend and unbend the wrist joint. Holding the stick in two hands extended side by side, rotate it left and right. We transfer the stick from one hand to the other. We sort through the fingers of a sore hand on a stick. We roll the ball away from ourselves and towards ourselves. As if spinning a light bulb, rotate the ball with your fingers in one direction and the other. The same, but the arms are outstretched. Throw the ball from one hand to the other. We press the palm of the hand on the ball from above and weaken the pressure. On both sides we squeeze the ball with our palms. With a healthy hand we throw the ball, and with a sick hand we pick it up.

Shoulder exercises. “Window”: putting the diseased hand on top of the healthy one, we form a “frame” and make a turn, moving the “window” to the left and right. We raise and lower our hands in the castle, then we make circular movements with them. We do, without opening the arms, rotation of the shoulders back and forth. We raise our hands in the castle, spread apart and lower.

Leg exercises. Sitting on the floor, bend your knees, sliding your feet on the floor towards you and away from you. We take the straight leg to the side. Raise a straight leg and put it on the other. We pull one knee to the chest, then the other. We slide the foot along the lower leg of the other. Lying on your stomach, rest your feet on your toes and lift your knees off the floor. We swing, putting a sore leg on a healthy one. We crawl in a plastunsky way. Sitting on a chair, we roll from heel to toe and back. We part the heels, connecting the socks, and vice versa. Putting the diseased leg on a healthy one, we rotate the ankle joint.

And the complex of Mikhail Yakovlevich Gusev from Kineshma also helped me:

"Propeller" and "Scales". Take 2 walnuts in your hand and rotate them clockwise and back with your fingers. At first, the nuts will fall, then things will get better. Hold your arms bent at the elbows in front of your face, bending your fingers alternately. Then unfold them sequentially. With the edge of your right palm, begin to “cut” between the fingers of your left hand, then change hands. Such "cuts" normalize the pressure.

Keep your arms bent at the elbows in front of you so that the right hand is opposite the left chest, and the left hand is opposite the right. Make circular movements with the brushes, as if winding a thread around a ball: the right hand rotates around the left hand, the left around the right. Imitate the movement of a football player throwing the ball in from behind (the sample is on the TV screen). "Propeller": leaning forward, arms extended to the sides, rotate up and down. "Scales": alternately raise the shoulder to the ear, the other - as far as possible down. (Exercise can be done in front of a mirror).

"Tug of war". Alternately fingering, slowly and straining all the muscles of the arms, legs, back, pull up an imaginary rope. "Archery": straining the muscles of the arms, legs, back, pull the "bowstring" as much as possible and, having "released the arrow", relax.

"Bike". Lying on the back is good for paralysis. Keeping your hands in front of your chest and fingers locked, try to turn your hands outward, then stretch up. Pass the tennis ball from one outstretched hand to the other, also keeping your hands behind your back as high as possible. The pace is maximum.

After relaxing all the muscles, try to portray the walk of a drunken man, if you can, dance to the music, laugh (without tension). Then relax, shake alternately with each arm and leg, then with both arms, leg and arm at the same time. Hold on to a chair to keep from falling.

In addition to these complexes, Chinese gymnastics for the elderly "Tai-Dee" helps me. In addition to gymnastics, I go to the bathroom in cold water, pour cold water on my hands and feet. I also practice singing different sounds and songs.

My successes are as follows: now I can tie a dressing gown at the back, dress myself and go for a walk, peel potatoes and cook food, and I can do a lot more after stroke immobility. And I want to say to all stroke patients: faith in healing and daily exercises are the surest remedy. Just do not feel sorry for yourself, gymnastics should be performed daily. Make yourself an indulgence, consider that everything will go down the drain, you will have to start over. So I wrote this letter with my right paralyzed hand. Let it not be quite beautiful yet, but I hope that handwriting will normalize over time. And the above complexes were sent by people who responded to my misfortune. I have tried them all and can testify: they help stroke patients.

Stroke: Symptoms and First Aid. It is important

Stroke is a terrible word. This vascular disease claims a huge number of lives every year. The insidiousness of a stroke is that it can happen imperceptibly, or, on the contrary, it can develop rapidly and lead to death in the very first hours. In 10-13% of cases, stroke affects young people.

How to recognize it, and what can be done before the doctor arrives?

A stroke is a violation of cerebral blood supply, which inevitably leads to the death of part of the brain cells. There are hemorrhagic and ischemic strokes. Hemorrhagic stroke occurs as a result of cerebral hemorrhage and subarachnoid hemorrhage (bleeding into the space between the arachnoid and arachnoid membranes of the brain). Ischemic stroke occurs, as a rule, due to blockage, and as a result, the cessation of blood flow through the vessels that feed the brain. The cause may be a blood clot, an air bubble, or a particle of fat that has entered the bloodstream and blocked it. Ischemic strokes are the main form of acute disorders of cerebral circulation and account for more than 80% of all types of stroke.

Read also: Fainting: Causes and First Aid

Although a stroke is considered to be a disaster for people after 45-50 years old, it also affects young people (in rare cases, adolescents under 18 years old). Young people make up 10-13% of the total number of people affected by a stroke. Men in their 40s and 60s are twice as likely to have a stroke as women. At the age of 60, the picture changes: after menopause, women are admitted to the hospital with this diagnosis much more often than men of the same age. The likelihood of complications in women at this age is also twice as high.

A stroke attack can occur, as it seems, literally “out of the blue” - the reasons that lead to it are invisible to the eye. Active treatment must be started in the first 3-8 hours from the onset of a stroke - later the chances of returning a person to a full life are sharply reduced. The refusal of the patient from hospitalization and the hope that "it will resolve itself" is tantamount to signing a death warrant.

How to recognize a stroke? The situation should be alert when your loved one suddenly turns pale or blushes, falls, stumbles out of the blue, complains of a sudden and severe headache, does not understand the speech addressed to him or cannot speak, stumbles. Doctors advise learning a simple phrase to remember the signs of a stroke: speech - face - hand"(In place of the" hand "you can substitute the" leg "). That is, if a person’s speech or understanding is suddenly disturbed, his face is distorted, his arm (leg) is weakened or does not move, these are signs of a stroke. If even one of these signs appears, you should immediately call an ambulance.

A more detailed list of signs of a stroke:

- Sudden weakness or loss of sensation in the face, arm or leg. Usually in a stroke, these disorders are asymmetrical - they focus on one half of the body. Since each hemisphere of the brain is responsible for the opposite half of the body, damage to one of them causes violations of the "controlled" side: the right hemisphere - the left arm, leg or half of the face, the left hemisphere - the right side of the body.

- Sudden blurred vision in one or both eyes, blurred vision, double vision.

- Difficulty speaking or understanding simple sentences.

- Dizziness, loss of balance or coordination. The person stumbled out of the blue, began to stagger, fell - especially when combined with other symptoms, such as impaired speech, double vision, numbness, or weakness.

- Sudden severe headache.

- Vegetative signs of a stroke - fever, accompanied by increased sweating, palpitations, dry mouth.

- Loss of consciousness. The patient's face becomes purple-red, the pulse is tense and slow, breathing is deep, frequent, often wheezing, the temperature rises, the pupils do not react to light. Often immediately revealed paralysis of the limbs, asymmetry of the face. In this case, the paralyzed side is always opposite to the lesion in the brain.

A simple stroke test. Be sure to ask your loved one to complete these simple tasks if you have even the slightest suspicion of a stroke:

- Ask the person to smile. With a stroke, the victim will either not be able to do this, or his lips will curl to the side.

Ask them to say a simple sentence, like "It's raining today." A person affected by a stroke will not be able to pronounce words clearly.

Ask them to raise both hands. If your loved one has a stroke, they may not be able to raise their arms, or may only be able to do so partially.

Ask him to stick out his tongue. If the tongue is twisted, turned to the side - this is also a sign of damage to one of the hemispheres of the brain.

- ask the patient to tilt his head forward and press his chin to his chest. If a person has had a stroke, then performing this movement will cause him difficulty.

If the victim has difficulty with at least one of these tasks, immediately call an ambulance.

What can be done before the arrival of the doctor:

- Calm the patient and calm yourself as much as possible.

- Lay the patient down, avoiding sudden movements, it is better that the head is turned to one side. Be sure to turn your head to the side if the victim is vomiting. Otherwise, there is a risk of choking on vomit.

- Open the window - there should be fresh air in the room.

- Measure the pressure. If the patient has high blood pressure or a hypertensive crisis, you can take one tablet of captopril (Capoten) or Corinfar. In no case do not try to sharply reduce the pressure: optimally - a decrease of 10 - 15 mm Hg. Art. from the original.

- You can give a tablet of glycine or nootropil. If the patient is unconscious, these medicines can be dissolved in water and dropped into the mouth with a dropper.

- Reception of no-shpy, papaverine and other vasodilators in stroke is contraindicated.

Wife stole dead husband's brain!

What are the most important symptoms of a stroke, and why should you go to the hospital as soon as possible?

Healthy? Yes 22

The most important symptoms stroke. which ordinary people need to know in order to immediately sound the alarm and call an ambulance - this is a weakness in two limbs, an arm and a leg on one side - not necessarily: it may just be a weakness in the arm that suddenly arose. The skewed face, that is, if the face was simply skewed, there was a normal person, but here he was skewed. Some kind of strabismus, if the eyes move in different directions, or vision is lost in one eye, and then it is restored. Or, for example, some kind of speech disorder, that is, a person can either speak in such a way that no one understands him, or he cannot find words, for example, he forgot the name of some object, or he cannot explain something himself angry, or does not understand anything. In all such cases, you need to call an ambulance, because most likely this stroke .

If a person has a long-term memory loss, and it gets worse and worse, and he does not think well, then this is most likely just a chronic circulatory disorder of the brain. But if a completely normal person who walked well, moved his arms, talked to relatives suddenly abruptly, for example, his right hand was taken away, or suddenly relatives see that his face is twisted, or they see that a person cannot say something or speaks, but nothing is clear, or cannot swallow and speaks poorly, then these can all be symptoms stroke. and the sooner the patient arrives at the hospital, the more likely it is that he will fully recover, and the help will be effective in treatment.

Because if a person arrives in four days or a week, he says: “Doctor, somehow my arm has not been moving for a week, I somehow got worried, for the first three days I thought that I was in bed, for the second two days I wanted to go to the clinic, finally, I called an ambulance a week later, "in this case, it will be very difficult to restore the function of the hand. That is, the chances will be much worse than if he arrived in the first hours after development stroke. Because then it is still possible with the help of drugs to restore blood flow in the affected vessel and resume blood supply to the affected area, and it is possible to save some more areas and reduce the area of ​​​​the deceased brain, so it is more likely to restore function.

It happens that a person does not feel himself, but he can either see in the mirror, or see that one cheek moves worse, or food falls out of his mouth, but some people somehow do not notice this, if they are elderly people, they can speak and consider that they are speaking normally, and other relatives will immediately see that something bad has happened.

That is, just don’t think when such symptoms occur, especially speech disorders, movements in the limbs, if half of the body is completely numb, you don’t feel it at all - then it’s better to call an ambulance. Because there is numbness against the background of high blood pressure, there is numbness against the background of osteochondrosis - this also occurs, not necessarily stroke. But there are clear signs: when half of the body does not move or it starts to move poorly, worse than usual, it is better to play it safe to some extent and come to the hospital.

The person himself should be embarrassed in principle that his right hand does not move. So it could just be nerve damage. Nerves pass in some of these narrow channels, and due to bones and tendons, they can be squeezed, and some function may fall out. Often people come to the hospital, for example, their arm is hanging, that is, they are afraid stroke. but in fact their arm dangled, because their radial nerve was affected after sleep: they slept uncomfortable, it pinched, and this function flew out. That is, it is not stroke. but simply nerve damage and a completely different condition. But in any case, if this arose, you need to go to the hospital.

If, for example, a patient is in a coma, he has different pupils, that is, one pupil is much larger than the other - this is visible, then this is a high probability that he has a cerebral hemorrhage. The nerve is compressed, which provides constriction of the pupil on one side, and the pupil expands, because no one constricts it: the nerve is compressed - the pupil has expanded. That is, you should also look at the pupils, if you can see that there are two pupils and one is much larger than the other - it catches your eye, then there is a high probability of hemorrhage or something is squeezing in the brain. This is not a fact, but a high probability. You need to call an ambulance right away.

You can do harm with drugs, because, for example, high blood pressure needs to be brought down, but not critically, because the brain is already poorly supplied with blood and it is believed that with ischemic stroke the pressure can be lowered, but not much, because the brain does not receive oxygen anyway, and if the pressure is still completely reduced. Therefore, if stroke just happened, it is better to immediately call an ambulance, right now, urgently and go to the hospital. Because now there is a program for thrombolysis, a new federal program, very strong, actively sponsored. That is, if a person enters within 4.5 hours from the onset of development stroke to the hospital, if this is a young man under 80 years old, without contraindications, there are a sufficiently large number of them, then he is injected with a medicine intravenously, into a vein, which interacts directly with this blockage, with this plaque or with this thrombus, and dissolves it, and the blood flow resumes . The prognosis there is very different: it helps someone better, someone worse, but the bottom line is that a person got in the first 4.5 hours from the beginning stroke .

In fact, if a person arrives at least on the first day from the onset of the disease, then just a dropper with ordinary saline, with conventional medicines, has a healing effect, that is, they restore sometimes and often lost blood flow, and the brain begins to receive better blood supply. And if you do nothing on the first day, then the likelihood of recovery is much worse. That is, it is trivial to simply put a dropper in order for the liquid to enter the bloodstream and stimulate the restoration of this clogged vessel. If the vessel has only recently been clogged, then it is still possible to recanalize it, that is, restore blood flow. And if it has been clogged up for a long time, a clot has already formed there, which can no longer be broken through, then, of course, it is already difficult to restore.

If a vessel has ruptured, then this problem is more complicated, because if there is a hemorrhage in the brain, then it can displace the brain, as if squeezing it, and therefore there is already joint work with neurosurgeons. Neurosurgeons look, if the patient fits the indications, then they take him for surgery, remove the hemorrhage from the brain. If neurosurgeons believe that there is no point in the operation, then they treat the patient simply with various drugs that increase blood viscosity. That is, on the contrary, the opposite treatment than with ischemic stroke. there, on the contrary, it is necessary to thin the blood, but here, on the contrary, it is necessary to thicken it, there are also such means. Or there are drugs that dissolve the blood in the brain, they are also prescribed.

But this is quite difficult, because if there is a large hemorrhage, it squeezes the brain, then such people are often incompatible with life, they die immediately, and they can die in hours, and it is no longer possible to help them, even if taken for an operation. And there are patients in whom this hemorrhage resolves or becomes smaller under the influence of drugs, and they recover very well, and then become normal people. That is, maybe something remains, some minor violations, but they can walk and talk very well.

It all depends on where the hemorrhage occurred. Because there are hemispheres of the brain, and there is a trunk. This is directly between the spinal cord and the hemispheres themselves, there is also a brain stem itself. It consists of different parts, and there are also a lot of important centers located there. And if a hemorrhage occurred in this trunk, and there is a center that regulates breathing, which regulates vascular tone and cardiovascular activity in general, if a large hemorrhage occurs there, then there is usually very little chance. And if there is ischemia, then there is also very little chance. That is, it is better when strokes directly in the hemispheres of the brain, there you can still somehow compensate, and with a hemorrhage in this trunk, the prognosis is much worse.

There is another large group of diseases, for example, multiple sclerosis, they can also sometimes begin acutely. A tumor may also begin, some kind of infectious lesion of the brain may also begin acutely. That is, a very large group of diseases that can manifest themselves in this way. But if it is old age, then doctors naturally begin to think about stroke. more likely.

The first thing that every person automatically pays attention to when meeting or communicating with other people is their faces. At the same time, that slight asymmetry of the face that is present in each of us is not even noticed, that is, a slight difference in the shapes, distances and sizes of one half from the other. Asymmetry is an individual feature, an external characteristic of each person. Absolutely symmetrical faces do not exist in nature. The asymmetry of the oval of the face and, in general, its individual sections, distinguishes even identical twins with its indicators.

It can be physiological and pathological in nature and professionally is of interest to specialists in many specialties - in neurology, cosmetology and plastic surgery, dentistry and maxillofacial surgery, psychology, anthropology and forensic medical examination. What could be the reasons and what to do with a strong asymmetry of the face?

Causes of Facial Asymmetry

A certain percentage of people turn to cosmetologists or plastic surgeons precisely because of the asymmetrical arrangement of facial elements. However, most often the disproportion of the latter is determined by a cosmetologist when examining for the correction of any other defects or by a plastic surgeon who is planning, for example, a volume plastic surgery.

The shape and symmetry of all points depends on the structure of the bones and cartilages of the facial skull, the degree of development, volume and tone of the facial and masticatory muscles, passing nerves and vessels, the volume and thickness of the subcutaneous fatty tissue, etc.

Of the many formations of the facial skull, including bone and cartilage structures, the most important cosmetic and aesthetic formation is the nose. Its shapes and sizes not only determine aesthetics, but are also the main ones in cases of asymmetry formation. The latter, if you look closely, can be expressed in irregularities or differences in the contours of the eyebrows, in different shapes of the corners of the mouth and the depth of the nasolabial folds, in different sizes and shapes of the auricles, the position of the wings of the nose, etc.

Video: Asymmetry of the face and skull. Distortion of the face, crooked face and skull. Osteopathic treatment

Facial asymmetry correction is not always necessary. The lack of ideal symmetry not only of the face, but also of other parts of the skeleton and body as a whole is due to individual anatomical and morphological features of development, both congenital in nature and various causes that arise throughout life. Visually, the violation of symmetry is almost not noticeable and occurs in almost all people. The deviation of proportions, which is no more than 2-3 mm or 3-5 degrees, is considered a physiological norm.

The approach to deciding whether and how to remove facial asymmetry is significantly influenced by the diagnosis of possible causes. Due to the nature of the causes (namely, pathological deviations from conditionally correct proportions), all asymmetric conditions are combined into three large groups:

1. congenital
2. acquired
3. combined

Congenital asymmetry of the face

It is caused by anomalies associated with a genetic predisposition or disorders of a different nature that have arisen in the process of intrauterine development of the fetus. These include mainly:

• anomalies in the development of the bones of the facial skull;
• underdevelopment of the lower jaw;
• incorrect formation of the temporomandibular joint;
• defects in the development of connective tissue or mimic muscles;
• unilateral defect of the sternocleidomastoid muscle with the development of torticollis;
• strabismus.

Acquired

If facial asymmetry appeared after birth, then this defect refers to an acquired pathology. The main causes of the acquired disproportion are the consequences of:

• traumatic injuries of bone structures and inflammatory processes in the area of ​​the mandibular joints;
• pathological processes in chewing and mimic muscles;
• improper development of the dentition, malocclusion and, in general, any abnormal condition of the dentoalveolar system;
• neurological diseases.

In this case, neurological pathology is the main one and is represented by the most numerous problems, leading to mimic violations of proportions. This block mainly includes:

• neuropathy of the facial nerve, or Bell's palsy (the most common cause of facial asymmetry - up to 25 cases per 100,000 population);
• traumatic injuries, including surgical, and other lesions of the facial nerve;
• post-paralytic mimic contracture with increased tone of the muscles of the same name on the opposite side;
• synkinesis of a pathological nature (motor-motor and motor-vegetative) associated with neuropathies and characterized by muscle spasm of facial muscles, dyskinesia of facial muscles; elimination of facial asymmetry in synkinesis is relatively simple; it can be easily corrected by introducing microdoses of botulinum toxin into the lacrimal gland or the circular muscle of the eye;
• pain syndromes in any areas of the face;
• asymmetric myasthenic syndrome.

Neurology especially deeply considers the causes of disproportion. Her conclusions are necessarily taken into account in cases where a plastic surgeon and even a cosmetologist need to choose the treatment of facial asymmetry.

Synkinesia of the facial muscles

The relation of neurology to the causes of imbalances

Mimic asymmetry, first of all, from the point of view of neurology, is determined by the lack of symmetry in the cerebral hemispheres. Each of the cerebral hemispheres regulates sensations (sensors) and motility of the corresponding halves of the body in different ways. At the same time, the perception of facial expressions by one person also depends on the state of interaction between the hemispheres of the brain in a particular person.

Neurology as a science considers symmetry issues as its subjective perception by the observer. In other words, the conclusion of one person about imbalances may be erroneous - another observer, due to the peculiarities of the interaction between the hemispheres of his brain, may come to the opposite conclusion. Therefore, the following types of asymmetry are distinguished in neurology, which are also accepted in cosmetology and plastic surgery in the final decision on how to correct facial asymmetry:

Static or morphological type

This type of symmetry breaking is characterized by the presence of differences in the state of rest between individual elements in size, structure, shape and proportions. The reasons for these differences are the individual developmental features, the pathology of the bones of the facial skull, the pathology of the masticatory and mimic muscles, the consequences of diseases and traumatic injuries.

Types of asymmetry
A Static or morphological
B Dynamic or functional

Dynamic or functional type

Consisting in non-synchronous contractions of the facial muscles and manifested during facial expressions. So, for example, an imbalance that is absent at rest, or a moderate imbalance at rest, respectively, appears or is significantly enhanced by smiling or stretching the lips in the form of a tube. The dynamic form of asymmetry is associated with congenital or acquired pathology of facial muscles, residual effects of damage to the facial nerve of the central (impaired cerebral circulation) or peripheral nature in the form of Bell's palsy. In this case, the severity of imbalances depends on the degree of damage (neuropathy) of the facial nerve.

Facial asymmetry correction

The therapy of the pathology in question is based on the diagnosis of the cause, the establishment of the type and degree of the pathological condition, and the appointment of treatment for the corresponding pathology in combination with the use of neurotrophic methods.

Since the most common cause is neuropathy of the facial nerve, the main principles of treatment are:

1. The use of appropriate specific (neurological) traditional drug therapy.
2. Injections of botulinum toxin preparations on the “healthy” and / or affected side.
3. The use of stabilized hyaluronic acid fillers.
4. Surgical correction or thread lifting.

In addition, in almost all cases, gymnastics against facial asymmetry and electrical stimulation procedures can be applied (in the absence of contraindications to their implementation).

Bolulinum toxin injections

In order to carry out botulinum therapy, briefly described above, various preparations of botulinum toxin "A", in particular "", "" and, especially, "" can be used. With paralysis and paresis, correction by these means is carried out on a healthy (conditionally) half of the face, since it is here that an increased muscle tone is formed. In the case of synkinesis, muscle contractures and hyperkinesis, injections are carried out mainly in dependent muscles. Very often, such a correctly performed dose-dependent therapy makes it possible to restore facial symmetry within 4-6 months without surgery.

Surgical treatment of facial asymmetry

Video about correcting facial asymmetry with a botulinum toxin-based device

Dermal gels

At the next (after botulinum therapy) stage, contouring and correction of soft tissue volumes are carried out through the application. These drugs as part of complex therapy (surgical treatment and botulinum therapy) make it possible to achieve high functional and aesthetic results in patients with long-term and severe forms of mimic muscle paralysis.

Preparations of stabilized hyaluronic acid allow not only to eliminate the disproportion of areas and restore the aesthetic state, but also have a pronounced therapeutic effect, due to the improvement of microcirculation and trophic processes in tissues.

Optimum experts in neurology consider plastic hypoallergenic, devoid of cellular and gene toxicity, fillers based on hyaluronic acid of a new generation with a special three-dimensional structure of the line "" of the Swiss pharmaceutical concern "Hyal Intertrade SA". Contouring is carried out using classical filler injection techniques - linear, fan-shaped, multipuncture, "mesh".

Neuropathy of the facial nerve on the right
And the initial state
The picture after botulinum therapy (Lantox) and injection plasty (Bellcontour)
From condition to
D after volumetric correction

Surgical treatment and thread lifting

In cases where the asymmetry is characterized by significant severity (more than 5 cm in total), surgical correction is required, since conservative methods of treatment are not able to provide satisfactory results, not only in functional terms, but also in aesthetic terms.

At the same time, in case of paresis, local injuries of the terminal sections or the first branch of the facial nerve, in the presence of certain concomitant diseases or the patient himself refuses surgical treatment, correction by means of a minimally invasive (lift) is possible. It is usually carried out in combination with botulinum therapy and correction after surgery with stabilized hyaluronic acid fillers or during surgery with autofat (). The combination of these methods can significantly improve the patient's condition, significantly improve the quality of his life and facilitate his social adaptation.

Thread lift correction

Exercises for facial asymmetry

They can be different, but the main ones are:

1. Slowly and forcefully frown your brows.
2. Close your eyes as much as possible, then quickly relax your eyelids.
3. Raise your eyebrows as much as possible while lifting the upper eyelid.
4. Strongly stretch forward the lips folded into a tube while pronouncing the sound "I".
5. Alternately smile with the corners of your lips.
6. To imitate the maximum breath with the wings of the nose pressed with the fingers.
7. Slowly move the lower jaw alternately to the right and left sides, holding it in extreme positions for 2 seconds.
8. Move the tongue in a circle along the inside of the cheeks and lips in front of the teeth.

During the exercises, it is desirable to carry out special loads on the problem half. The number of repetitions of each exercise on the problem side should be at least 20, on the healthy side - at least 10.

The adequacy of the correction completely depends on the assessment of the degree of imbalances, the diagnosis of their causes and the choice of the correct therapy algorithm.

Such a symptom as a skewed face is not uncommon in medical practice. This is not just a cosmetic defect, various neurological diseases can be hidden behind this symptom. They can be both non-serious, not requiring specific treatment, or severe, requiring immediate consultation with a specialist. Let's see why the face can be skewed, and what to do when this happens. After all, everyone can face this problem.

Distorted face: reasons

Basically, various neurological diseases are hidden behind the change in the facial muscles. Below are the main reasons:

• paralysis of the facial nerve;
• blepharospasm;
• acute cerebrovascular accident - stroke.

The most dangerous condition listed above is a stroke. It requires immediate medical attention and hospitalization, as prompt initiation of treatment increases the chances of successful rehabilitation.

Above is a photo with a twisted face of a woman who suffered a stroke.

Paralysis of the facial nerve: causes

As one of the conditions that can cause the face to look crooked, it requires appropriate treatment to restore the original shape of the face. Paralysis is the inability to move any part of the body, in this case, the muscles of the face. A number of pathological conditions can lead to this:

• infectious diseases (chicken pox, herpes, rubella), which lead to inflammation of the facial nerve - neuritis;
• inflammation of the middle ear - otitis;
• traumatic brain injury;
• inflammation of the meninges - meningitis;
• brain tumors.

Fortunately, all of the serious causes listed above (brain injury, tumors, meningitis) are rare. But in most cases, the cause of the paralysis cannot be found out, and then the doctors diagnose "idiopathic Bell's palsy." This condition is the most common cause when a child's face is distorted.

Paralysis of the facial nerve: symptoms

Damage to the facial nerve is characterized by the fact that the face is skewed on one side only, and asymmetry of the entire face is observed. This means that the patient has both the lower part of the face (the corner of the mouth is lowered, he cannot bare his teeth, the tongue deviates to one side), and the upper part of the face (one eye is closed or the eyelid is lowered).

When diagnosing this pathology, the doctor may resort to such additional examination methods:

• electromyography - the study of facial muscles by recording the signals that come from them;
• magnetic resonance imaging - imaging of the brain using a tomograph, which will help to exclude brain damage (tumor, trauma, stroke).

Paralysis of the facial nerve: treatment

What to do if the face is distorted with facial paralysis? There are a number of pharmacological and non-pharmacological treatments that will help restore the appearance and function of the facial muscles:

• corticosteroids - relieve inflammation of the facial nerve;
• antiviral or antibacterial agents, if the presence of an infectious process is confirmed;
• surgery for a diagnosed brain tumor;
• massage;
• a set of exercises for facial muscles;
• physiotherapy;
• moisturizing eye drops on the affected side, antibiotic ointments to prevent infection.

Blepharospasm: causes and symptoms

Another condition in which the face can distort is blepharospasm - an involuntary contraction of the circular muscle of the eye surrounding it.

Main reasons:

• Facial paraspasm is a disease characteristic mainly of the elderly. Its exact cause is unclear, but it is believed that paraspasm appears due to an imbalance in the parts of the nervous system.
• Parkinson's disease.
• Meningitis.
• Multiple sclerosis.
• Inflammation of the eyes (keratitis, conjunctivitis).
• Sinusitis - inflammation of the paranasal sinuses.

With blepharospasm, only the upper part of the face is asymmetric: the palpebral fissure gradually narrows, sometimes the eye can suddenly close. This brings a lot of inconvenience to the patient.

Blepharospasm: treatment

If the face is distorted with blepharospasm, you should turn to the following therapeutic methods:

• treatment of the underlying disease that caused spasm of the circular muscle of the eye;
• physiotherapy;
• nootropics - drugs that increase the delivery of oxygen to the brain and improve its functioning;
• with severe symptoms and the ineffectiveness of other methods of treatment, it is possible to prescribe botulinum therapy, which effectively relieves muscle spasm.

Stroke: causes

One of the most dangerous causes of facial asymmetry and impaired facial expressions is a circulatory disorder of the brain, resulting in a stroke often develops. Depending on the cause that caused it, it can be ischemic (with blockage of a cerebral vessel by a thrombus or embolus), as well as hemorrhagic (with a rupture of a thinned wall of a cerebral vessel).

The main conditions that increase the risk of stroke are:

• cerebral atherosclerosis is one of the main causes of ischemic stroke;
• arterial hypertension - increases the risk of hemorrhagic stroke;
• aneurysm of a cerebral vessel - a sac-like protrusion and thinning of the wall of a cerebral vessel, as a frequent consequence of prolonged arterial hypertension;
• chronic disorders of cerebral circulation;
• obesity and low physical activity.

Stroke: symptoms

If the face is distorted during a stroke, you should immediately consult a doctor, since time plays a very important role here. Therefore, you need to know the following signs that will help to suspect the development of a stroke:

• In the vast majority of cases, asymmetry of only the lower half of the face is characteristic, which is manifested by a lowered corner of the mouth, smoothness of the nasolabial fold, deviation of the tongue to one side, inability to show teeth or stick out the tongue completely.
• Paralysis (complete immobilization) or paresis (weakness) of the limb, and unilateral damage to the arm and / or leg is characteristic. It is difficult for the patient to raise his arm or he cannot stand up; with paresis of the leg, walking is possible, but difficult.
• Violation of speech, and the patient can be damaged, both the center of understanding speech, located in the frontal lobe of the brain, and the center of pronunciation, located in the temporal lobe. In the first case, the patient pronounces words and sentences absolutely normally, but they do not understand at all the meaning of what they say to him. In the second case, he understands everything, but is either completely unable to say anything, or speaks separate incoherent words.

If you notice any of these symptoms in yourself or in your environment, do not hesitate, call an ambulance immediately!

Stroke: treatment

Therapy for circulatory disorders should be started as early as possible, since an early start increases the likelihood of a successful restoration of muscle function, including facial muscles. Therapy depends on the type and cause of the stroke.

With cerebral ischemia, drugs are prescribed that resolve the thrombus and restore normal blood circulation (acetylsalicylic acid, thrombolytic therapy).

In hemorrhagic stroke, it is necessary to stop bleeding in the brain tissue, which is achieved with the help of antifibrinolytic therapy (alpha-aminocaproic acid).

However, not only drug therapy plays a role. With a satisfactory condition of the patient, it is necessary to start physiotherapy exercises and massage as soon as possible to restore muscle function.

In most patients, symptoms begin to improve within a few weeks; full recovery takes three to six months. Approximately 10% of patients experience recurrence of facial neuritis; sometimes it affects the other side of the face. In a small number of patients, the symptoms of neuritis of the facial nerve to varying degrees persist throughout life.

Symptoms of neuritis of the facial nerve

• Sudden weakness or complete paralysis of the muscles of one side of the face.
• Half of the face looks saggy; the use of facial expressions is significantly difficult.
• Pain in the jaw or ear on the affected side of the face.
• Increased sensitivity to sounds.
• Headache.
• Deterioration of the ability to taste.
• Altered salivation and lacrimation (usually increased).
• Rarely, facial neuritis affects nerves in both sides of the face.

If there are signs of paralysis of the facial muscles, consult a doctor immediately, as this may be caused by a stroke. True facial neuritis is not associated with a stroke.

If you have facial weakness, also see your doctor to identify or rule out some serious medical conditions that may be causing these symptoms.

Causes

The most common cause of facial neuritis is the herpes simplex virus. , various types of which cause colds on the lips and genital herpes. Somewhat less often, neuritis of the facial nerve is caused by other viruses:

• Herpes zoster (it also causes chickenpox and shingles)
• Epstein-Barr virus (causative agent of mononucleosis)
• Cytomegalovirus
• Risk factors for the development of neuritis of the facial nerve:
• Pregnancy, especially during the first trimester
• First week after childbirth
• Diabetes
• Upper respiratory tract infections

Some patients who are prone to relapse of this disorder have a family history of facial neuritis. It is assumed that they have a genetic predisposition to develop this disorder.

Complications

With mild forms of neuritis of the facial nerve, its symptoms disappear without a trace within a month; more severe forms, however, can cause the following complications:

• Irreversible damage to the facial nerve.
• Incorrect growth of nerve fibers, which leads to the involuntary movement of some muscles when a person tries to use others - synkinesis. For example, when a person smiles, his eyes may close involuntarily.
• Partial or complete loss of vision caused by the inability to lower the eyelids and, as a result, excessive dryness of the eyes.

Diagnostics

A simple physical examination is usually sufficient to diagnose facial neuritis. If the diagnosis is in doubt, electromyography or medical imaging techniques may be used.