Question
A 53-year-old patient, who has been in good health, suddenly felt numbness on the right side of his face. This morning, he noticed his eyelid drooping and his mouth was crooked. What could this be? The family is very worried.
Answer
Based on the patient’s description, facial paralysis is a likely diagnosis. First, it is necessary to distinguish between central and peripheral facial paralysis. If both sides of the forehead wrinkles when frowning are present, it may be central facial paralysis, usually caused by brain lesions such as cerebral infarction or hemorrhage, or space-occupying lesions. A brain MRI is required to rule out these possibilities. If it is peripheral facial paralysis, the most common type is Bell’s palsy, which is related to a simple herpesvirus infection. Other causes include Hunt’s syndrome, middle ear disease, or tumors, and further examinations are needed. Treatment methods include nutritional nerve treatment, antiviral therapy, corticosteroids, acupuncture, physical therapy, traditional Chinese medicine, and for some patients, facial nerve decompression surgery may be required. It is recommended that the patient visit the clinic as soon as possible for an appointment.