Evaluation and treatment of synkinesis with botulinum toxin following facial nerve palsy.

Abstract

PURPOSE:

To assess the effect and efficacy of botulinum toxin type A (BTX-A) in reducing synkinesis in aberrant facial nerve regeneration (following facial paralysis).

METHOD:

A total of 55 sessions of BTX-A (Botox) infiltration were performed on 30 patients (23 female) with synkinesis after facial palsy. Each subject was injected with 2.5 units of BTX-A in each injection site (the sites were chosen on a case-by-case basis). The synkinetic muscles targeted include: orbicularis oculi, zygomaticus major, depressor labii inferioris, platysma, healthy frontalis and healthy corrugator supercilii. The patients were examined using the Sunnybrook Facial Grading System, both before the BTX-A treatment and after an average of 35 days.

RESULTS:

All 30 patients experienced improvement to the synkinesis after treatment. Total scores: median pre-BTX-A: 40; post 53 p = 0.004. Resting symmetry scores: mean pre-BTX-A -7.1; post: -3.5; median pre -5 [interquartile range (IQR) -10 to -5]; post: -5 (IQR -5 to 0); p = 0.0001. Symmetry of voluntary movement median pre-BTX-A: 56 post 60 p = 0.10. Synkinesis scores: median pre-BTX-A: -9 post -3 p < 0.0001. Mean duration of improvement was 4 months.

CONCLUSIONS:

BTX-A injection treatment was effective in reducing facial synkinesis, thus improving facial expression symmetry both at rest and in voluntary movements.

• Authors: Elena Dalla Toffola, Francesco Furini, Carla Redaelli, Elena Prestifilippo, Maurizio Bejor
• Journal: Disability and rehabilitation (Disabil Rehabil) Vol. 32 Issue 17 Pg. 1414-8 ( 2010) ISSN: 1464-5165 [Electronic] England
• PMID: 20156046 (Publication Type: Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Adult
• Aged
• Botulinum Toxins, Type A (therapeutic use)
• Facial Expression
• Facial Paralysis (complications)
• Female
• Humans
• Male
• Middle Aged
• Neuromuscular Agents (therapeutic use)
• Severity of Illness Index
• Synkinesis (classification, drug therapy, etiology)