Berke Özücer, MD
Baskent University, Istanbul - Turkey Monday-Friday: 0900-1800 Saturday: 0900-1400 +90-216-554-1500

Partial Facial Paralysis and Synkinesis

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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.

synkinesis treatment after facial palsysynkinesis

What are the symptoms?

synkinesis treatment after facial palsy

  • 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.

  1. Botox
  2. Synkinesis surgery (soon)
  3. Synkinesis Physical therapy (Neuromuscular rehabilitation)

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.

Posted Comments
  • rose
    rose
    Hello, I had facial paralysis in 2007, I was treated for nearly 3 months. After electro shock, radiation therapy, massage and medications, there was a small amount in my eyes, nose, mouth, and I started talking again while laughing, eye shrinking, stretching, lip pulling started. If I started using Prednol, do you mind? he didn't give me that. *
    reply
  • Berke Özücer, MD
    Berke Özücer, MD
    I replied to your e-mail, get well soon. Dr. Berke Özücer
    reply
  • Hamza nayır
    Hamza nayır
    Hello, about 9 months ago I had a facial paralysis. Currently, there are problems in the corner of the lips, eyebrows and eyes. I wonder if treatment is possible, I would be glad if you could help.
    reply
  • Ertugrul Baskaya
    Ertugrul Baskaya
    My wife had a partial swimmer 34 months ago on the right side of 29/05/2016. He still has not been fully recovered. There are symptoms around the eyes, lips. There is also a situation you call synkinesis. There are currents on the paralyzed side. We have been doing reflex therapy for 6 months. Our doctor says there is improvement. But it goes slow. What can we do for faster recovery? Can we get a full recovery?
    reply
  • Halil Kütük
    Halil Kütük
    Hello. My name is Halil. Sir, I had facial paralysis on the left side in 2007. During this period, no treatment other than medication was applied. There were small residues when I was laughing or opening my eyes wide, but lately my left eye has started to fall out of tiredness. As I said, there are minor nerve-related troubles on my face, but eye drops become very uncomfortable. Is there anything to do about this?
    reply
  • Sebahattin TURAN
    Sebahattin TURAN
    Good day, Mr. Berke, I was born in 1990 and I had facial paralysis in the winter of 1999. There was a curvature of the lips and not closing the eyelid, etc. The next day we went to the doctor immediately and had physical therapy for 2 months.In physical therapy, muscle movements were first and then with work and electricity. . Now, after 19 years, I still have a muscle fold line on the left side of my face close to my nose. Will my nose be corrected with a slightly curved plastic surgery? How many days should I rest after the plastic surgery? Manager Thank you if you reply.
    reply
  • Leyla freckle
    Leyla freckle
    Mrb teacher, I have facial paralysis for 2 years, my facial spasms started, I am not as bad as I was first, but I am not as good as before, my gestures work very little. What do you suggest me please help me.
    reply
  • Aysun hill
    Aysun hill
    About 5 or 6 months ago I had facial paralysis.I had physical therapy for 10 days, but I had a pain in my ear when I was eating something with a pipette, and I had pain in my ear. I can see physical therapy again. How can I heal?
    reply
  • ali osman stopped
    ali osman stopped
    Hello, I have a curvature in my fetus from birth, I have been told that my gums do not work. How is the amliyat process? Is there any risk? What difficulties I will encounter in the post-operative period.
    reply
  • There is Selda
    There is Selda
    My teacher, I had a right side facial paralysis 8 months ago when I was pregnant. There is improvement in my face, but my eyes are narrowing, I will be very glad if you can give information about the progress of your surgeries.
    reply
  • lightning bolt
    lightning bolt
    Hello. I had facial paralysis on the right side of me diagnosed with Ramsey Hunt syndrome on 14.02.2018. I took prednol, antivirals, ftr and acupuncture. but it was not enough. remained at the edge of the eye and mouth. While smiling, eating (I never raise my head) while talking, my right eye squints and I get very uncomfortable. There was little left on the lip, but my priority was also my eyes and ears, and also external ear inflammation appeared. has been going on since my stroke. I also started having problems with my jaw closing. my dentist said that you are clenching your teeth, the ENT dr.um said there is nothing to do, briefly I do not go to the dr, I do not know what to do .... I am writing from Ankara. what path can we follow? Thank you
    reply
  • lightning bolt
    lightning bolt
    I had facial paralysis on the right side of me diagnosed with Ramsey Hunt syndrome on 14.02.2018. I took prednol, antivirals, ftr and acupuncture. but it was not enough. remained at the edge of the eye and mouth. While smiling, eating (I never raise my head) while talking, my right eye squints and I get very uncomfortable. There was little left on the lip, but my priority was also my eyes and ears, and also external ear inflammation appeared. has been going on since my stroke. I also started having problems with my jaw closing. my dentist said that you are clenching your teeth, the ENT dr.um said there is nothing to do, briefly I do not go to the dr, I do not know what to do .... I am writing from Ankara. what path can we follow? Thank you
    reply
  • Yilmaz Agaoglu
    Yilmaz Agaoglu
    Hello .. At the end of March, facial paralysis occurred on the left side. There was severe pain behind the ear for 15 days before. In the morning when paralysis occurred, two vesicles appeared under the chin. It was said that it was due to shingles. I used cortisone and antiviral for fifteen days. I started to recover. By the way, I had physical therapy and acupuncture with it. Three months ago, while I was eating, my eyes were closed and I was living. So SYNKINESIA occurred. I read your suggestions on this subject. I wonder if mine is different and would you have a special suggestion for it. Thank you very much.
    reply
  • iron ayan
    iron ayan
    Hello, my teacher, since yesterday morning there is a fall on my lower left lip, it stays still while laughing, but when I am talking or normally closed, my mouth does not have any trouble, yesterday mr was withdrawn, he said there was no problem, neurologist gave muscle relaxants how can I get rid of this situation my teacher is a temporary thing
    reply
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