Facial Synkinesis

Facial paralysis synkinesis involves abnormal synchronization of facial movements, leading to involuntary actions during voluntary movements of different muscle groups.

​

Common signs include:

Narrowing of the eyes when smiling

Cheek lifting when closing eyes

Neck muscle tightening when whistling

Facial twitching and tightness

Formation of a deeper cheek crease

Consultation with a doctor is recommended for diagnosis and appropriate treatment.

​

Symptoms may include:

Increased muscle tone on the affected side, requiring more effort to move muscles

Shortening and tightening of facial muscles, hindering expression

Linked facial movements due to poor insulation of recovering facial nerve

Coordination difficulties in facial movements

Various facial muscle patterns may be observed, such as challenges with eye closure or inappropriate smiling.

Other signs include chin dimpling, eye narrowing, increased spasms, and neck and cheek tightness.

​

 

Preventing Synkinesis:

While synkinesis cannot be prevented, patients can adopt certain measures to mitigate its impact post-Bell’s palsy.

"Facial re-education" entails teaching patients various facial exercises to minimize synkinesis effects. These exercises involve actions like maintaining facial elevation while speaking and chewing with eyes open.

Treatment may span up to four months, focusing on gradual improvement in facial muscle coordination.

 

Synkinesis Treatment Options:

Synkinesis treatment encompasses three modalities: surgery, neuromuscular retraining, and Botox injections.

 

Treatment initiation post-diagnosis is feasible, even years after Bell’s palsy onset.

 

Selective neurolysis, or modified selective neurectomy, is a leading surgical.

It rectifies facial nerve "mis-wiring," enhancing smile symmetry and muscle coordination.

Other treatments include static suspension of mouth corners, blepharoplasty, and asymmetric facelifts.

Botox injections target overactive facial muscles, reducing synkinesis effects.

 

Physical Therapy and Neuromuscular Retraining:

These therapies emphasize coordinated facial muscle movements to combat synkinesis.

Manual massage and stretching alleviate muscle tension without stimulating muscle strengthening.

Exercises are predominantly home-based, with therapists providing personalized regimens.

 

Synkinesis Treatment Consultation with Dr. Boonipat:

A consultation entails comprehensive evaluation and personalized treatment planning by Dr. Boonipat.

Realistic recovery expectations are set, and patients receive detailed preparatory instructions for treatment.