International Journal of Clinical and Experimental Neurology
ISSN (Print): 2379-7789 ISSN (Online): 2379-7797 Website: Editor-in-chief: Zhiyou Cai, MD
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International Journal of Clinical and Experimental Neurology. 2015, 3(1), 1-3
DOI: 10.12691/ijcen-3-1-1
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Synkinesis of Facial Musculature in a Patient with Facial Paralysis

Khurshid A Mattoo1, , Manas Singh2 and Pooja Arora3

1Department of Prosthodontics, College of dentistry, Jazan University, Jazan, (KSA)

2Department of Prosthodontics, IDEAS, Madhya Pradesh University of health sciences, M.P (India)

3Department of Prosthodontics, Subharti Dental College, Subharti University, Meerut, India

Pub. Date: January 09, 2015

Cite this paper:
Khurshid A Mattoo, Manas Singh and Pooja Arora. Synkinesis of Facial Musculature in a Patient with Facial Paralysis. International Journal of Clinical and Experimental Neurology. 2015; 3(1):1-3. doi: 10.12691/ijcen-3-1-1


Facial Synkinesis is a clinical condition that is the sequel to facial nerve paralysis which develops during nerve repair like axon myelination and regeneration. Involuntary muscle activity is accompanied by voluntary muscle activity and may involve facial and extra ocular muscles. This article describes an uncommon variation of facial Synkinesis that manifested clinically in weak voluntary chewing and frequent cheek biting in the form of mucosal erosion on the buccal mucosa. Managing a case of facial paralysis that has associated facial Synkinesis has also been discussed.

cranial nerve motor bells palsy skeletal muscle neuromuscular junction

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[1]  Rubin DI, Matsumoto JY, Suarez GA, Auger RG. Facial trigeminal synkinesis associated with a trigeminal schwannoma. Neurology, 1999; 53 (3): 635-7.
[2]  Buckley EG, Ellis FD, Postel E, Saunders T. Post Traumatic Abducens to Oculomotor Nerve Misdirection. Journal of AAPOS, 2005; 9 (1): 12-16.
[3]  Beurskens CH, Heymans PG. Mime therapy improves facial symmetry in people with long-term facial nerve paresis: a randomized controlled trial. Aust J Physiother 2006; 52 (3): 177-83.
[4]  Nakamura K, Toda N, Sakamaki K, Kashima K, Takeda N. Biofeedback rehabilitation for prevention of synkinesis after facial palsy. Otolaryngol Head Neck Surg, 2003; 128 (4): 539-43.
[5]  Manikandan N. Effect of facial neuromuscular re-education on facial symmetry in patients with Bell's palsy: a randomized controlled trial. Clin Rehabil. 2007; 21 (4): 338-43.
[6]  Pfeiffer N, Simonsz HJ, Kommerell G. Misdirected regeneration of abducens nerve neurons into the parasympathetic pupillary pathway. Graefes Arch Clin Exp Ophthalmol, 1992; 230 (2): 150-3.
[7]  Montoya FJ, Riddell CE, Caesar R, Hague S. Treatment of gustatory hyper lacrimation (crocodile tears) with injection of botulinum toxin into the lacrimal gland. Eye, 2002; 16 (6): 705-09.
[8]  Mehta RP, Robinson WM, Hadlock TA. Validation of the Synkinesis Assessment Questionnaire. Laryngoscope, 2007; 117 (5): 923-6.
[9]  Kothari M, Hussain A, Kar D, Toshniwal S. Primary superior oblique muscle-levator muscle synkinesis. J Aapos. 2007; 11 (2): 204-5.
[10]  Choi D, Raisman G. After facial nerve damage, regenerating axons become aberrant throughout the length of the nerve and not only at the site of the lesion: an experimental study. Br J Neurosurg. 2004; 18(1): 45-8.
[11]  Sadjadpour K. After Postfacial palsy phenomena: faulty nerve regeneration or ephaptic transmission? Brain Res. 1975; 95 (2-3): 403-6.
[12]  Moran CJ, Neely JG. Patterns of facial nerve synkinesis. Laryngoscope 1996; 106 (12): 1491-6.
[13]  Brach JS, VanSwearingen JM, Lenert J, Johnson PC. Facial neuromuscular retraining for oral synkinesis. Plast Reconstr Surg. 1997; 99 (7): 1922-31.
[14]  Beurskens CH, Heymans PG, Oostendorp RA. Stability of benefits of mime therapy in sequelae of facial nerve paresis during a 1-year period. Otol Neurotol 2006; 27 (7): 1037-42.