Causes

There are many different causes that can cause a facial nerve to become inflamed. Often, neuritis is accompanied by prior damage to the nerve tissue. This can happen, for example, through constant pressure on the nerve tissue, which can be caused by tissue changes or tumors.

A toxic neuritis is, as the name suggests, caused by toxins. Relevant here are not only pollutants coming from outside (e.g. heavy metals), but also metabolic toxins such as those produced by diabetes mellitus or chronic alcoholism. If the nerve is subjected to mechanical stress, for example if it is cut, torn or squeezed, traumatic nerve inflammation can result.

The cause is often the contact between a blood vessel in the brain and the nerve. In this case, the conduction paths rub against each other and the protective sheath (myelin sheath) of the nerve is worn away – irritation and false stimulation, for example of the pain fibers, occurs. Another source of inflammation can be multiple sclerosis.

In this chronic inflammatory disease of the central nervous system (CNS), the myelin sheaths are attacked and dissolve. While the causes already mentioned are not transmissible, neuritis resulting from an infestation with bacteria, viruses or other microorganisms can also be dangerous for contact persons. A variety of pathogens can attack the CNS and trigger an inflammation in the facial nerve.

Symptoms and facial neuralgia

Inflammation can affect various facial nerves. There are 12 so-called brain nerves. These are called so because they are directly connected to the brain and have no contact with the spinal cord.

Only two of these nerves contain sensitive nerve fibers – fibers that can perceive touch and pain – the trigeminal nerve and the glossopharyngeal nerve. The trigeminal nerve (“triplet nerve”) is divided into three main branches that sensitively supply the face (with eyes, nose and mouth), the teeth and the front two-thirds of the tongue. These are the nervus ophthalmicus (“eyeball nerve”), the nervus maxillaris (“maxillary nerve”) and the nervus mandibularis (“mandibular nerve”).

The nervus glossopharyngeus, the second sensitive cranial nerve, supplies the middle ear and pharynx, as well as the back third of the tongue with nerve branches that are sensitive to touch and pain.In addition, sensors that can measure and influence blood pressure are connected to the brain via a side branch of the nervus glossopharyngeus. If these nerves are inflamed, information can be misdirected. The nerves are irritated and send, for example, false pain signals.

This is called neuralgia. The symptom of pain in the context of an inflammation of the facial nerve can be differentiated in different ways. Here, one must distinguish between acute pain and chronic pain.

The acute pain is caused by an acute trigger. The acute pain has a protective function and is a warning signal. It correlates with the trigger.

This means that if the blow or the injury or inflammation in the face is strong, the pain is also strong. If the damage is minor, the triggerable acute pain is also relatively minor. If the pain is chronic, it is independent of the trigger.

They have no protective function. Furthermore, the qualities of the facial pain can be determined to find out whether the nerves, muscles and/or bones in the face are affected. Pain in the face can also be divided by quality into deep and surface pain.

Deep pain here usually involves pain originating in the facial muscles and bones. A surface pain in the face is caused by an injury to the facial skin. Here, we differentiate between the 1st and 2nd pain.

The 1st pain is usually described as bright and easily localized. The 2nd pain has a dull pain character and is difficult to differentiate. This pain quality is also often described in deep pain.

The different qualities are due to the different nerve fibers that conduct the pain. In the course of an inflammation of the facial nerve a neuropathic pain can develop. This means that the pain originates from the nerve cell, the neuron. This results in hyperactivity of the pain perception system in the brain. Neuropathic pain is described as burning, electrifying, very strong and often devastating.