Girl demonstrating synkinesis following Bell's palsy.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.

Treatment is centered on 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.

Diagram of a nerve cell, called a neuron.
Call the us today for a consultation regarding your facial paralysis or synkinesis.