What Is Facial Nerve Injury?
What Is Facial Nerve Injury?
Injury
Treatment depends on the cause of the facial nerve injury. Imaging, such
as computed tomograpy (CT) and Magnetic Resonance Imaging (MRI)
may be performed to localize the site of injury. Additionally,
electrodiagnostic tests may be performed to evaluate facial nerve
function. A discussion with your physician should take place to determine
whether non-conservative treatment (i.e. surgical repair) or conservative
treatment (i.e. physical therapy) would be most appropriate. Additionally,
since eye closing ability may be affected, lubricating eye drops or eye
patches may be prescribed to prevent excessive eye drying and irritation
during sleep.
Pathophysiology
Neuropraxia
Nerve Recovery and
Mechanism of Ischemia or
Injury compression.
Regeneration
Effect of Injury Nerve structure
remains intact but Following injury nerves sprout to recover
conduction slows function. Nerve regeneration occurs at a
down.
rate of 1 mm/day. The extent of nerve
Recovery Occurs within recovery is dependent on the amount of
hours-weeks.
scarring around the nerve, the proficiency of
Axonotmesis blood flow around the nerve, and the
degree of inflammation.
Mechanism of Crush injury.
Injury
Effect of Injury Axon is disrupted
Re-training the Facial
but myelin sheath
is intact. Nerve
Recovery Dependent on
A trained physical therapist may work with
severity of injury;
Motor function you to help you recover muscle function.
may return, but is Your therapist may prescribe you a series of
not guaranteed. exercises to help maximize facial muscle
Occurs within function recovery.
weeks-months.
Neurotmesis General Exercise Principles:
Mechanism of Damage extends
Injury through the • Slow and small movements to start
majority of the • Focus on motor control and coordination
nerve • Use of a mirror to ensure symmetric muscle
movements
Effect of injury Decreased nerve
• Emphasis on QUALITY of movements, not
conduction.
Recovery Recovery is quantity
uncertain and
complete Avoid the use of electrical stimulation during the first 6-
recovery may be 12 months. Please consult with a physician.
rare. It typically
takes 6 months to
determine if there
is any return of
function.
• What is Synkinesis?
o Unwanted movement of the facial muscles during voluntary movement.
o Examples: eye closure with smiling, neck tightening with mouth movement, cheek lifts with
eye closure, facial tightness.
o Botox can be used to relax overactive or tight muscles. Please consult your physician.