Partial Facial Paralysis and Synkinesis
What is partial facial paralysis?
Full facial paralysis (House-Brackmann 6) does not show facial muscle tone (flaccid / muscles relaxed). There was a complete sagging and immobility on the face - in the corner of the mouth, in the eyebrow, under the eye. On the contrary, there is partial recovery in partial facial paralysis, so involuntary contractions on the face are seen in partial facial paralysis. Unwanted facial movements and complete facial paralysis are different situations. If the resting face of the person shows a good image, the person cannot have full facial paralysis. Suboptimal recovery in the nerves may be the cause of abnormal facial appearance and facial movements. In other words, it is a condition that appears in partial facial paralysis.
What does synkinesis mean? What is synkinesis?
Synkinesis, in the muscles involuntary contraction / movement means. After partial facial paralysis (after Bell's paralysis, facial paralysis after ear surgery, facial paralysis after salivary gland, etc.), it occurs with involuntary contractions that develop outside the control of the person on the face. Treatment of permanent facial paralysis takes an important place.
What causes synkinesis?
A healthy neither normal facial nerve is divided into roughly 5 branches. It is seen as a result of wrong healing as a result of misalignment of the addresses of the cables in the facial nerve during the recovery / repair that occurs after the facial nerve damage. It is not seen in full facial paralysis, it is seen in partial facial paralysis. For example, if the nerve to the eye goes to the corner of the mouth after recovery, or vice versa, the person will smile involuntarily when the eye falls, squinting or closing the eye. This situation creates abnormal synchronization in facial movements and various symptoms occur.
What are the symptoms?
- Constriction / shrinkage / strain in the eye while smiling
- Involuntary smile during eye closure
- Neck tightness while whistling
- Involuntary tics and muscle spasms on the face, cheek and jaw
- Dimpled chin, orange peel appearance
- Facial muscle tension, constant stiffness, hypertonicity
Does synkinesis go away without treatment?
It is frequently seen 3-4 months after facial nerve damage / facial paralysis. Getting the right treatment after Bell paralysis reduces the likelihood. If left untreated after partial facial paralysis, it is unlikely to resolve on its own.
Is there a cure for synkinesis?
It is necessary to mention three main treatment methods with scientific validity in treatment.
Face shadows targeted in treatment
- Paralyzed side, muscle around the eye (orbicular muscle)
- Paralyzed side, neck muscles (platysma)
- Paralyzed side, corner of the mouth muscles
- Paralyzed side, jaw muscle
The healthy side can also be targeted for the treatment of facial asymmetry:
- Firm side, forehead muscles
Synkinesis Physical Therapy: Neuromuscular Rehabilitation
Contrary to popular belief, physical therapy methods used in full facial paralysis and synkinesis differ. Recoordination is a priority rather than strengthening the stimulation of the muscles in physical therapy. Therefore, muscle-strengthening exercises and stimulation with electricity, for example, are not recommended.