Face muscle strain

[Varghese2000]

The person having both face, having muscle strain, especially when we are smile. Circumstances : When we meet new person try to smile, very difficult. That time face is more strain and smile will not come. Face shape is become more bored. Now he is hiding from friends,relatives and group function. Last 3 years gradually it is going more.

Please can you give the solutions. He is having B.P last 5 years and it is in controlled.

[caregiver222]

The paralysis of the facial muscles is linked to a palsy of the cranial nerves, specifically the eighth nerve. Swelling develops around this nerve which then does not conduct the messages to the face. Usually this is on one side of the face only. You can draw a line down from the forehead over the nose. It is called Bell's Palsy. There are many reasons why this can happen. Often the problems develops, lasts a few weeks and goes away. Then comes back. Sometimes the cause remains a mystery. It can be due to viral  infection, or a benign neuroma (growth), and develop with Parkinson's disease. It can lead to what is called a "stone face" which is very frightening. On a short-term basis a steroid, such as prednisone is often used to reduce the inflammation. Long-term use of prednisone is contraindicated because of the immune system depression and development of malignancies. Some cases can be treated surgically. A CT scan, MRI and MRA is essential. Anti-inflammatories such as NSAIDS (Ibuprufin) are helpful, if there is no liver damage. Gentle massage of the face on a daily basis helps, as does rubbing with an ice-cube. Have the patient look in a mirror each day and try to activate the muscles. Speech therapy is helpful because the paralysis often goes down to the lips. Sometimes drooling develops and either a teary or dry eye. Remission is common, but not guaranteed, so don't give up hope.

[Varghese2000]

Dear Sir,

Thank you so much for your valuable evaluation. We will do it.

[S. Kaul, MD]

Hi there!

Well, without a detailed clinical evaluation it would be difficult to determine the cause of his symptoms and without a diagnosis at hand it is difficult to suggest a management plan. Possible causes of the symptoms that may need to be considered include neuro-degenerative disorders, neurological lesions, muscular issues, hormonal/ endocrine abnormalities, micronutrient deficiencies etc. I would suggest considering a detailed evaluation by an internist initially and depending on the cause diagnosed/ suspected it can be managed accordingly or specialist (rheumatology/ neurology) may be sought.
Hope this is helpful.

Take care!