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What Is Facial Nerve Injury?

Facial nerve injury can occur due to trauma, tumors, Bell's palsy, or inflammation. It leads to impaired facial muscle function and potential paralysis. Treatment depends on the cause but may include imaging, electrodiagnostic tests, surgery, or physical therapy. Recovery depends on the severity of injury and can range from hours to never fully recovering. Physical therapy focuses on slow, controlled exercises to regain muscle function and avoid developing unwanted muscle movements (synkinesis).

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0% found this document useful (0 votes)
26 views3 pages

What Is Facial Nerve Injury?

Facial nerve injury can occur due to trauma, tumors, Bell's palsy, or inflammation. It leads to impaired facial muscle function and potential paralysis. Treatment depends on the cause but may include imaging, electrodiagnostic tests, surgery, or physical therapy. Recovery depends on the severity of injury and can range from hours to never fully recovering. Physical therapy focuses on slow, controlled exercises to regain muscle function and avoid developing unwanted muscle movements (synkinesis).

Uploaded by

Usama Khan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Facial Nerve

Injury

What is Facial Nerve Injury?


Common causes of facial nerve injury include trauma, compression from a
tumor, Bell’s palsy, and compromise secondary to inflammation. The facial
nerve controls many muscles of the face, including those that control eye
closing, smiling, and frowning. Despite the mechanism of injury, compromise
of the facial nerve leads to decreased ability of the facial nerve to transmit
messages from the brain to the facial muscles. Impaired facial nerve
function can lead to facial weakness or paralysis.

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

Nerve injuries are classified according


to the degree of injury. The following is
an overview of the main types of nerve
injury:

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.

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Frequently Asked Questions

• How long should it take to recover?


o Most patients should have some recovery within the first 2-4 weeks, however, complete
recovery may take up to 6 months. If you have facial paralysis without recovery for more than
6 months you should see a physician immediately.

• What treatments should I avoid?


o Electrical nerve stimulation applied incorrectly or at the wrong time could increase your risk of
synkinesis therefore should be avoided.

o Accupuncture - the current available evidence is insufficient to support that acupuncture is


an effective therapy for facial palsy due to the poor quality of research into the area.

• 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.

• Who develops Synkinesis?


o Everyone who develops facial paralysis will develop some degree of synkinesis. However, the
degree will vary from patient to patient. The more severe your facial paralysis is at the onset,
the likelier you’re your synkinesis will be more noticeable.

• How do you treat Synkinesis?

o Biofeedback and facial re training with a physical therapist

o Facial massage and stretching

o Botox can be used to relax overactive or tight muscles. Please consult your physician.

For more information:


• USC Facial Nerve Center -- http://ent.keckmedicine.org/treatments-services/facial-
nerve-center/
• Information about Facial Palsy -- http://www.facialpalsy.org.uk/inform/what-is-facial-
palsy/
• Information about Synkinesis -- http://www.facialpalsy.org.uk/support/patient-
guides/synkinesis-advice/

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