Does the cold wind make your face crooked? These things about "facial paralysis"

The beginning of summer has passed, and the heat is gradually disappearing. After a few days, the temperature will gradually approach autumn. There is also a folk saying "Don't expose your body during the White Dew", which warns us to pay attention to the temperature. There is a disease that many people often say will appear when the cold wind blows, and this is facial paralysis.

What is facial paralysis? In layman's terms, it is caused by facial nerve lesions, which lead to facial muscle paralysis. It can be understood that the muscles that control our facial expressions are not under command. Common unilateral facial paralysis is manifested by the inability to frown on the affected side, difficulty closing the eyes, drooping corners of the mouth, and cheek leakage. Because there is a healthy side for comparison, it can usually be identified at a glance. Some actors in the entertainment industry are called "facial paralysis faces" mainly because of their serious expressions and the fact that the expression muscles on both sides are basically motionless. Of course, this is a joke, and true bilateral facial paralysis is extremely rare.

More than 20 years ago, when I was taking the course "Otorhinolaryngology" in college, I talked about facial paralysis. I still remember an interesting story the teacher told me. He said that before liberation, many barbers were good at treating facial paralysis. They often brought some Chinese medicine plasters. If anyone had a patient with facial paralysis, they would call the barber and apply a dose of ancestral plaster, and the patient would recover in a short time. This teacher was humorous and very good at teaching. He is now the director of a well-known tertiary hospital. Later I learned that there were indeed many barbers in the past, called barbers in some places, who would also make some Chinese medicine plasters, especially a kind of "golden wound medicine". If you accidentally scratched your face while shaving, you could make and sell it yourself. As an aside, it is said that in the late Qing Dynasty, Li Cheng, a barber in Anyang, discovered that the "golden wound medicine" made from "dragon bones" with words on them had a wonderful effect. These "dragon bones" with words gradually became popular, and were later sold to Chinese medicine pharmacies. They were eventually discovered by Wang Yirong, the chief priest of the Imperial College in Beijing, and the "oracle bone script" finally saw the light of day again. The unofficial history about barbers has long been difficult to tell true from false. Apart from the proverb "the barber's pole is hot on one end" left as evidence, the plasters in their poles have also been blown away by the wind.

A hundred years ago, many folk doctors and barbers may have overlapped in their identities. They all walked the streets and used traditional medical methods. The same was true in the West four or five hundred years ago. Doctors were responsible for internal medicine, and barbers were responsible for surgery. Bloodletting treatment was particularly popular at that time. In addition to shaving, the barber's knife also served the task of cutting veins. After liberation, many outstanding folk Chinese medicine practitioners were retained and entered the system, becoming well-known Chinese medicine inheritance brands. For example, in the field of facial paralysis treatment, many old Shanghainese people recognize a small Chinese medicine hospital in the west of the city, which has a good reputation.

Back to today's topic, most of the facial paralysis in life is peripheral facial paralysis. The facial nerve starts from the brain center, passes through the internal auditory canal, passes through the parotid gland after exiting the skull, and is finally distributed on the face. If the lesion is located below the motor nucleus of the facial nerve in the pons, it can be called peripheral facial paralysis. Conversely, if the lesion is located in the center, it is called central facial paralysis. The most common type of peripheral facial paralysis is Bell's palsy. Although the specific cause is unknown, mental trauma and cold wind stimulation are often inducing factors. Scientists have isolated herpes simplex virus and immune complexes from patients' facial nerve biopsy specimens, so it is generally believed that the disease may be related to viral infection and the resulting series of nerve edema, venous return disorders, etc.

Since the cause of the disease is generally believed to be facial nerve damage and a series of subsequent microscopic reactions such as edema, the treatment, in addition to antiviral treatment, is mostly centered around how to restore the facial nerve, including improving oxygen and blood supply, improving microcirculation, eliminating edema, and nourishing nerves. In our otolaryngology or neurology department, we generally use glucocorticoids, antiviral drugs, vasodilators, vitamins and other drugs for treatment. Similarly, traditional Chinese medicine treatment methods are also effective, including traditional Chinese medicine, acupuncture, etc. For some hospitalized patients, if time permits, we will also treat them with a combination of Chinese and Western medicine.

Many people say that facial paralysis is a self-limiting disease and will get better without treatment, which is not accurate. The common Bell's palsy generally has a good prognosis, and most patients can recover their facial expression function, but there will be a few patients who will have some sequelae even with active treatment. In addition to Bell's palsy, other types of facial paralysis have a relatively poor prognosis. For example, there is a type of facial paralysis that has a poor prognosis, and only about 60% of patients will recover. When the disease occurs, a large number of herpes will appear in the ears at the same time. This is Hunt syndrome caused by herpes zoster, also known as herpes zoster oticus. Some patients with facial nerve tumors will also experience facial paralysis on the affected side, and once it occurs, it is difficult to recover. There are many diseases that cause facial paralysis. Once it occurs, you should still see a specialist for examination, clarify the cause, and be targeted. Don't be careless.

As the autumn wind blows, everyone should pay attention to the temperature and take care of themselves.