Summary about Disease
Facial diplegia refers to weakness or paralysis affecting both sides of the face. It's different from Bell's palsy, which typically affects only one side. Facial diplegia can result from various underlying conditions, ranging from neurological disorders to infections. The severity can vary from mild weakness to complete paralysis, impacting facial expressions, speech, and eating.
Symptoms
Weakness or paralysis on both sides of the face
Difficulty smiling, frowning, or making other facial expressions
Drooping of the eyelids or mouth on both sides
Difficulty closing the eyes completely on both sides
Slurred speech
Difficulty eating or drinking
Drooling
Changes in taste
Dry eyes or excessive tearing
Causes
Guillain-Barré syndrome (GBS): An autoimmune disorder that attacks the peripheral nerves.
Lyme disease: A bacterial infection transmitted by ticks.
Brainstem lesions: Damage to the brainstem due to stroke, tumor, or inflammation.
Möbius syndrome: A rare congenital neurological disorder.
Myasthenia gravis: An autoimmune neuromuscular disorder.
Sarcoidosis: An inflammatory disease that can affect multiple organs, including the nerves.
Infections: Certain viral or bacterial infections.
Medicine Used
The medications used depend entirely on the underlying cause of the facial diplegia. Examples include:
Guillain-Barré syndrome: Intravenous immunoglobulin (IVIG) or plasma exchange.
Lyme disease: Antibiotics (e.g., doxycycline, amoxicillin).
Myasthenia gravis: Cholinesterase inhibitors (e.g., pyridostigmine), immunosuppressants (e.g., prednisone, azathioprine).
Sarcoidosis: Corticosteroids (e.g., prednisone).
Symptomatic treatment: Eye drops for dry eyes, pain relievers, speech therapy.
Is Communicable
Facial diplegia itself is not communicable. However, if the underlying cause is an infection (like Lyme disease), the infection might be communicable through its specific transmission route (e.g., tick bite for Lyme disease). Guillain-Barré Syndrome (GBS) is not communicable.
Precautions
Precautions depend on the underlying cause. General precautions might include:
Eye care: Use artificial tears to prevent dry eyes, especially if unable to close the eyelids fully.
Oral hygiene: Practice good oral hygiene to prevent infections, especially if having difficulty swallowing.
Nutrition: Eat soft foods and take small bites to prevent choking if having difficulty swallowing.
Physical therapy: Follow prescribed exercises to maintain muscle tone and prevent contractures.
Preventing Lyme disease: Use insect repellent, wear protective clothing, and check for ticks after being outdoors in tick-infested areas.
How long does an outbreak last?
The duration of facial diplegia depends on the underlying cause and the effectiveness of treatment.
Guillain-Barré syndrome: Recovery can take weeks, months, or even years. Some individuals may have residual weakness.
Lyme disease: Symptoms may improve within a few weeks of antibiotic treatment, but some individuals may experience persistent symptoms.
Brainstem lesions: Recovery depends on the extent and location of the damage. Some individuals may have permanent deficits.
Myasthenia gravis: Symptoms can fluctuate, but with treatment, many individuals can achieve good control of their symptoms.
How is it diagnosed?
Medical history and physical examination: Neurological assessment of facial nerve function.
Neurological examination: Assessment of muscle strength, reflexes, and sensory function.
Blood tests: To check for infections (e.g., Lyme disease), autoimmune disorders (e.g., myasthenia gravis), and inflammatory markers.
Electromyography (EMG): Measures the electrical activity of muscles and nerves to help identify nerve damage.
Nerve conduction studies: Measure the speed at which electrical signals travel along nerves.
Lumbar puncture (spinal tap): To analyze cerebrospinal fluid for signs of infection or inflammation (e.g., Guillain-Barré syndrome).
MRI or CT scan of the brain: To look for brainstem lesions or other structural abnormalities.
Timeline of Symptoms
The timeline varies greatly depending on the underlying cause.
Guillain-Barré syndrome: Symptoms typically develop rapidly over days to weeks.
Lyme disease: Symptoms may appear weeks or months after a tick bite.
Myasthenia gravis: Symptoms may develop gradually over weeks or months.
Brainstem lesions (e.g., stroke): Symptoms appear suddenly.
Important Considerations
Facial diplegia can significantly impact quality of life, affecting communication, eating, and self-esteem.
Early diagnosis and treatment of the underlying cause are crucial to improving outcomes.
Multidisciplinary care, including neurologists, physical therapists, speech therapists, and ophthalmologists, may be necessary.
Psychological support may be beneficial to help individuals cope with the emotional and social challenges of facial diplegia.
Protecting the cornea is critical if eyelid closure is impaired.