Facial plast Surg 2000; 16(4): 361-364
DOI: 10.1055/s-2000-15546
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Facial Paralysis: Is There a Role for a Therapist?

H. Jacqueline Diels
  • Department of Rehabilitation Medicine, Neuromuscular Retraining Clinic, Rehabilitation Center, University of Wisconsin Hospital and Clinics, Madison, WI
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Publication History

Publication Date:
31 December 2000 (online)


Rehabilitation for peripheral facial paralysis is often neglected and patients are left untreated. This article explains how nonsurgical rehabilitation, specifically facial neuromuscular retraining, restores function in these patients. Patients with facial paralysis resulting from viral causes, postsurgical tumor resection, traumatic injury, or congenital paresis may be candidates for treatment. Typical patients present with flaccid paralysis acutely and may develop abnormal movement patterns (synkinesis) as recovery progresses. Neuromuscular retraining is effective. It provides specific strategies that inhibit synkinesis based on individual function and unique facial nerve and muscle properties. Successful rehabilitation results in improved patient satisfaction, self-esteem, and quality of life. Electrical stimulation should not be used at any time in facial rehabilitation. There is evidence that it may be contraindicated, and it is unnecessary. The imperative in treating synkinesis is to inhibit abnormally contracting muscles, not stimulate flaccid ones. The unfounded use of electrical stimulation is an unnecessary expense for patients and third-party payers.