Treating Longstanding Bell’s Palsy with Botox, NMR and Selective Neurolysis
For some Bell’s palsy patients, Botox alone is insufficient for long-term treatment. In fact, neuromuscular retraining (NMR) from an expert physical therapist commonly is used in conjunction with Botox injections to treat Bell’s palsy symptoms. Or, selective neurolysis is an advanced surgical option for long-term Bell’s palsy treatment.
Botox for Bell’s palsy addresses asymmetric facial movement. It relaxes unwanted facial muscle movements and reduces tension in facial areas that are hyperactive. By doing so, Botox counteracts facial weakness and uncoordinated movement of the facial muscles.
Eighty-five percent of Bell’s palsy patients recover completely and spontaneously within three months of initial diagnosis; these patients also recover on their own and without any therapy. But for the 15% of patients who do not fully recover from Bell’s palsy, unwanted facial movements persist.
NMR teaches Bell’s palsy patients how to isolate and relax facial muscles. It involves the use of subtle yet critically important exercises to improve coordination of the facial muscles and teaches Bell’s palsy patients which muscles are needed to control different parts of the face. For instance, many people believe the mouth muscles are required for smiling, yet the muscles that actually control smiling are located in the cheek. When the cheek muscles are used to create a smile, they pull the corners of the mouth upward. Thanks to NMR, Bell’s palsy patients can learn which muscles are needed to make a smile and retrain the brain to use only the correct muscles to make facial expressions.
NMR is generally administered about 10 to 12 weeks after an initial Bell’s palsy diagnosis. The longer it takes a patient to recover from Bell’s palsy, the more likely it the facial nerve will heal improperly. In this scenario, a Bell’s palsy patient may experience synkinesis.
Synkinesis occurs due to abnormal synchronization of facial movement. It causes involuntary facial movement when an individual moves a different muscle group. For example, if a Bell’s palsy patient tries to smile, his or her eye may inadvertently close at the same time. In these patients, the wrong facial muscles are flexing out of sequence, causing distorted facial movements. To address this issue, additional facial muscle coordination is needed.
Although Botox and NMR frequently help Bell’s palsy patients address facial paralysis and synkinesis, permanent paralysis of the face sometimes occurs. In this instance, selective neurolysis may be required to alleviate Bell’s palsy symptoms.
Selective neurolysis is a groundbreaking smile reanimation surgery developed by globally recognized facial plastic and reconstructive surgeon Dr. Babak Azizzadeh. The procedure involves mapping out the facial nerves with intraoperative electromyography (EMG) and decreasing nerve activity that otherwise makes it difficult to smile.
During a selective neurolysis procedure, Dr. Azizzadeh releases the platysma muscle that pulls the corner of the mouth down. This allows for spontaneous reanimation of the face and helps a Bell’s palsy patient achieve a natural-looking smile.
The downtime and risks associated with selective neurolysis are minimal in comparison to other facial nerve surgeries. Additionally, selective neurolysis is performed at an outpatient surgery center, and results can be seen as soon as one day following surgery.
Clearly, there are many surgical and non-surgical treatments to help Bell’s palsy patients address facial paralysis and synkinesis. If a person experiences Bell’s palsy symptoms, this individual should immediately go to an emergency room. But if Bell’s palsy symptoms linger for eight months or longer, Botox for Bell’s palsy or other advanced treatments may be required.
The Facial Paralysis Institute offers a wide range of comprehensive Bell’s palsy treatment options, including Botox, NMR and selective neurolysis. To find out more about how the Facial Paralysis Institute treats Bell’s palsy, please contact us today at (310) 657-2203 to schedule a consultation.
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