Synkinesis in the face is the result of involuntary movements during voluntary contractions. For example, when closing the eye or blinking, the corner of the mouth may twitch. Similarly, smiling may cause blinking. Synkinesis can be quite disconcerting for patients and is a source of social embarrassment for many. The phenomenon occurs usually after a bout of Bell’s palsy or other nerve injury and manifests in the recovery phase.
There are several theories as to why synkinesis occurs. When facial nerve function is altered or destroyed, a regenerative process begins whereby the intact portion of the nerve seeks its target in an effort to re-establish stimulatory pathways.
It is during this process that the nerve finds its way to different branches, especially in the central portion of the cheek where it arborizes extensively. Through redundant looped pathways, the branches can intertwine and become miswired. Similarly, target muscle cells may be neurotized unintentionally, contributing further to synkinesis.
There are several theories as to why synkinesis occurs. When facial nerve function is altered or destroyed, a regenerative process begins whereby the intact portion of the nerve seeks its target in an effort to re-establish stimulatory pathways. It is during this process that the nerve finds its way to different branches, especially in the central portion of the cheek where it arborizes extensively. Through redundant looped pathways, the branches can intertwine and become miswired. Similarly, target muscle cells may be neurotized unintentionally, contributing further to synkinesis.
Treatment is centered on the destruction of these abnormal pathways or by denervation of the unwanted muscles creating the twitch. This can be done with botulinum toxin injections or by selective surgical muscle excision and/or targeted nerve destruction. Again, facial retraining through physical therapy is a key factor in the management of synkinesis.
Call us today for a consultation regarding your facial paralysis or synkinesis.
following Bell’s palsy.
Why choose Dr Panossian
- He received his medical education at Tufts University School of Medicine.
- Graduated at the top of his class at UCLA, receiving Phi Beta Kappa and Summa Cum Laude honors.
- Was accepted into an elite combined general surgery and plastic surgery residency at the Keck School of Medicine of USC.
- Completed subspecialty training in craniofacial surgery at the Hospital for Sick Children in Toronto and Harvard Medical School.
- Was mentored by Dr. Ron Zuker in the practice of facial paralysis reconstruction. This prestigious fellowship position was available to only one surgeon in the United States.
- Is affiliated with various charitable and educational organizations, including Operation Smile and Mending Kids.
- Is a member of the American Society of Plastic Surgeons and the highly selective American Association of Plastic Surgeons, reserved for only a select group of individuals nationally who have demonstrated excellence in academic plastic surgery.
- Holds memberships in several other professional societies including the American College of Surgeons and the American Society of Reconstructive Microsurgery.
- He serves on the Board of Directors for Mending Kids and the Gondobay Manga Foundation, a non-profit organization dedicated to the improvement of lives in Sierra Leone.
- Has been nominated by his peers annually since 2012 as a “Super Doctor.”
- Served as an expert medical consultant and appeared on The Doctors, Grey’s Anatomy, and Nip/Tuck.
- Has been featured as “Top Doctor” in US News and World Report, Pasadena Magazine, and Los Angeles Magazine.
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Last modified by Dr. Andre Panossian
