What causes upper lip twitching? What is facial paralysis?

Early symptoms of facial paralysis

Typical symptoms: Most patients often find that one side of their cheek becomes stiff and their mouth becomes crooked when they wash their face or rinse their mouth in the early morning.

Changes in facial expression: If the facial expression muscles on the affected side are completely paralyzed, forehead wrinkles disappear, palpebral fissures widen, nasolabial grooves become flat, corners of the mouth droop, and the corners of the mouth deviate toward the healthy side when teeth are exposed.

Changes in facial movements: The affected side cannot frown, frown, close eyes, puff out air, or purse lips. When puffing out cheeks and whistling, air leaks out because the lips on the affected side cannot close.

Associated symptoms: When eating, food residues often remain in the buccal space on the affected side, and saliva often flows down from that side. Because the lacrimal points are turned inward with the lower eyelid, the tears cannot be drained normally and overflow.

Facial neuritis

Early symptoms of facial neuritis include ear root pain, rash, inability to frown or numbness on one side of the face, and gradual loss of taste. Many patients with facial paralysis mistakenly believe that they have other diseases when they first discover the symptoms and go to the ENT or dermatology department for treatment.

It is important to keep in mind the early symptoms of facial neuritis. Most patients often find that one side of their cheek becomes stiff and their mouth becomes crooked when they wash their face or rinse their mouth in the early morning. In patients with complete paralysis of the facial expression muscles on the affected side, forehead wrinkles disappear, palpebral fissures widen, nasolabial grooves become flat, corners of the mouth droop, and the corners of the mouth deviate toward the healthy side when teeth are exposed. The affected side should not frown, knit brows, close eyes, or puff out lips. When whistling with puffed cheeks, air leaks out because the lips on the affected side cannot close. When eating, food residues often remain in the buccal space on the affected side, and saliva often flows down from that side. Because the lacrimal points are turned inward with the lower eyelid, the tears cannot be drained normally and overflow.

Symptoms of trigeminal neuralgia

◎ Pain location: does not exceed the distribution range of the trigeminal nerve, is often limited to one side, and mostly affects one branch, with the second and third branches often affected, accounting for about 95%.

◎ Nature of pain: The pain is paroxysmal and presents as electric shock, knife-like, or tearing-like severe pain, which comes on and stops suddenly. Each pain lasts from a few seconds to tens of seconds. The intervals between attacks gradually shorten and the pain gradually worsens. Frequent attacks may affect eating and rest.

◎ Trigger factors and "trigger points": Pain attacks are often triggered by actions such as talking, chewing, brushing teeth, washing face, and even wind or noise can cause attacks. For some patients, touching the areas around the nose, mouth, gums, inner end of the eyebrow arch, etc. can cause pain attacks. These sensitive areas are called "trigger points" or "trigger points." Anesthetic "trigger points" can often provide temporary relief from pain attacks. Therefore, in order to reduce the attacks, patients often dare not wash their faces, speak loudly, or even eat.

◎Signs: The attack may be accompanied by spasms of the ipsilateral muscles, facial flushing, tearing and drooling, so it is also called painful convulsions. When the pain occurs, patients often rub the same side of the face with their hands. Over time, the facial skin becomes rough, thickened, and the eyebrows fall out. Because they are afraid to eat, wash their faces, and do not care about their appearance, patients often appear thin, haggard, unkempt, and depressed. Objective examination usually shows no signs of trigeminal nerve dysfunction or other localized neurological signs, but sometimes facial pain and touch sensation may be reduced due to rough and thickened facial skin or blockade treatment.

Four major clinical manifestations of facial nerve paralysis

1. Slanted mouth and crooked eyes: Most patients with facial nerve paralysis often find that one side of their cheek is not moving properly and their mouth is crooked when they wash their face or rinse their mouth in the early morning.

2. Inability to move: The affected side cannot frown, frown, close eyes, inflate, or purse lips. When puffing out cheeks and whistling, air leaks out because the lips on the affected side cannot close.

3. Paralysis of facial muscles: If the facial muscles on the affected side are completely paralyzed, forehead wrinkles disappear, palpebral fissure widens, nasolabial groove becomes flat, corners of the mouth droop, and the corners of the mouth deviate toward the healthy side when showing teeth.

4. Ectropion: When patients with facial nerve paralysis eat, food residues often remain in the buccal space on the affected side, and saliva often flows down from that side. Because the lacrimal points are turned inward with the lower eyelid, the tears cannot be drained normally and overflow.