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Long standing synkinesis

Synkinesis means unwanted facial movement, which is involuntary, for example, when a person smiles, they develop simultaneous and unwanted eye closure on the affected side.

In the early stage (acute synkinesis), when synkinesis first develops, it is often a welcomed sign of facial nerve recovery and signals progress.  Synkinesis is more easily treated in the early or acute stage before these abnormal movement patterns become ingrained.

In contrast, long-standing synkinesis refers to the stage when a person has been living with synkinesis for several months and possibly years.  Abnormal synkinetic movement patterns have become established and may be difficult to overcome.

Some people think that synkinesis will get better in time and may not seek help.  Others may access help but not follow through with their rehabilitation programme.

Synkinesis will not go away by itself but there is a great deal you can do to help reduce your synkinesis even at this chronic stage.

How to reduce synkinesis and improve movement patterns

  • Relaxation
  • Movement retraining
  • Daily muscle releases
  • Botulinum toxin injection into the affected muscles

Symptoms of long-standing synkinesis

You may have some or all of the symptoms in the list below, however, the list is not exhaustive, and you may experience other difficulties not mentioned here.

  • Generally, facial muscles continue to overwork becoming bulky, tight and shortened compared to the unaffected side.
  • Generally, the affected muscles will feel tight, tender and become immobile.
  • Shortened cheek muscles will lift the corner of the mouth and the cheek fold will be deep compared to the unaffected side.
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  • A shortened brow muscle (frontalis muscle) will lift the affected eyebrow which will sit in a higher position compared to the unaffected side.
  • The chin muscle (mentalis) can develop a dimple which is constantly present even when the face is at rest.
  • The muscles which pull the corner of the mouth downwards may shorten and constantly pull the corner of the mouth down.  This may inhibit the smile and people may misinterpret your feelings.
  • You may see thin bands of muscles popping out in your neck when you round your lips, smile or close your eyes.
  • The affected eye may close or narrow every time you chew, drink, yawn or smile.  This constant involuntary synkinetic movement around the eye ultimately makes the eye look smaller or narrow when compared to the unaffected side.
  • Tearing when you eat known as crocodile tears.

Common feelings associated with long-standing synkinesis

  • Feeling self-conscious as sometimes the synkinesis can distort facial expressions.
  • Worrying about the future because of how your face moves, feels and looks.
  • Feeling out of control because of a lack of information/knowledge about how to reduce your synkinesis.
  • Grief in response to losing the face that you once had.
  • Isolation in response to not knowing where to turn or what to do.
  • Anger at not getting the appropriate help in a timely fashion.

[ Add link to Read more 

  • Why is relaxation so important
  • Facial muscles and their function
  • Botox ]