Facial Palsy
Facial Palsy
Facial nerve palsy is a condition in which the facial nerve (cranial nerve VII) is compromised and results in paralysis of the muscles of facial expression. This usually occurs on one side of the face, but in rare cases it can affect both sides of the face.
Bell’s Palsy is the most common cause of facial palsy (60 – 75%). Other causes of facial palsy include Ramsay Hunt syndrome, Lyme disease, Acoustic Neuromas/Vestibular Schwannomas, parotid tumours, eclampsia/third trimester of pregnancy and Congenital facial palsies.
Bell’s Palsy is believed to be due to the herpes simplex virus, and is more common in people with diabetes, pregnant women and people over the age of 70. 85% of people with Bell’s Palsy achieve good recovery.
Patient education about facial nerve structure and function, nerve recovery and eye care are important, especially in the acute stage of recovery (the eye must be protected to prevent damage to the cornea). Facial Neuromuscular Retraining (FNMR) is an effective method for treating facial palsies that do not recover fully. FNMR involves soft tissue mobilization and specific retraining strategies to regain coordination and balance in your face. It is especially helpful when movements become abnormally connected, also known as synkinesis.
Initial examination:
This involves taking a complete history of the onset and specific symptoms of the facial paralysis, followed by a thorough evaluation of the muscles of facial expression. These appointments are typically 1.5 hours in length. Following the examination, patients are provided with extensive education regarding facial nerve palsy, self-care strategies to improve symptoms and specific movement retraining.
Follow up appointments:
These appointments are typically 1 hour in length and are for the purpose of progressing the FNMR program as you improve control of the muscles of facial expression. Appointments are usually spaced 3 – 4 weeks apart initially, with longer intervals between sessions once patients become more independent with self-treatment strategies.