Facial Synkinesis

Post-Paretic Facial Synkinesis

Post-paretic facial synkinesis is a condition that can occur after a facial nerve injury, commonly due to conditions like Bell’s palsy. When the facial nerve is damaged,
the muscles of the face may not function correctly, leading to weakness or paralysis. After some recovery, individuals might experience synkinesis,
where involuntary contractions occur in different facial muscles when attempting to move others. For instance, when a person tries to smile, their eye may unintentionally close.

Symptoms of Facial Synkinesis

The symptoms can vary widely from person to person but often include:

Muscle Spasms

As mentioned, these can include closing an eye when smiling or smirking.

Asymmetry

The face may appear uneven, with one side moving differently from the other

Impaired Expressions

Facial paralysis can hinder clear emotional expression and everyday activities like speaking and eating.

Discomfort or Pain

Some individuals experience discomfort due to the unusual muscle contractions.

Eye Dryness/Tearing

Because of the disrupted functioning of the eyelids, some might experience these symptoms

Causes

Post-paretic facial synkinesis primarily arises after a facial nerve injury. The damage causes a miscommunication within the nerve pathways leading to the facial muscles.
Instead of isolated, controlled movements, the brain may mistakenly trigger muscle groups that shouldn’t operate together.

Diagnosis

Diagnosis typically begins with a thorough physical examination, meticulously assessing facial muscle function and symmetry, coupled with a comprehensive review of the patient’s medical history to identify potential underlying causes.In certain instances, electrodiagnostic studies such as electromyography (EMG) and nerve conduction studies (NCS) are employed to precisely evaluate the electrical activity of facial muscles and nerves, pinpointing the location and severity of nerve damage

Treatment Options

Botox Injections

Botox, or botulinum toxin, has emerged as a leading treatment for post-paretic facial synkinesis. It works by temporarily relaxing the muscles that are overactive and causing unwanted movements. When injected into specific facial muscles, Botox can help achieve better control over expressions, allowing for a more balanced appearance. Many patients report significant improvements in facial symmetry and functionality after treatment, making it a popular choice.

Surgical Management

In cases where synkinesis is severe and impacts daily life significantly, surgical interventions may become necessary. These surgeries aim to re-establish proper nerve function and control over facial muscles.Procedures may include selective neurolysis and selective myectomies. A thorough evaluation by a qualified specialist can determine the best surgical approach based on specific needs.

Conclusion

Post-paretic facial synkinesis is a complex condition that can significantly impact daily life. Understanding the nature of synkinesis, its symptoms, and the available treatment options is crucial for those affected and their families. With the right support and treatment, many individuals can work towards improved facial function and a better quality of life. If you or someone you know is experiencing these symptoms, Consult us for proper assessment and guidance.

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