PATTERNS OF FACIAL-NERVE SYNKINESIS

Facial nerve synkinesis is an extremely distressing sequela of facial paralysis, and its prevention and treatment are less than adequate. Im proved therapeutic interventions await better understanding of its pat hogenesis. In this study, 11 patients with synkinesis and 11 normal co ntrol subjects were quantitatively assessed using a new computer-assis ted, motion-sensitive system. Two additional, informative cases presen ting at the completion of the study are also briefly reported. The obs erved synkinetic patterns appear predictable and nonrandom. In additio n, these observations tend to raise doubts that the aberrant fiber reg eneration hypothesis is the sole explanation of synkinesis. They furth er implicate facial nuclear hyperexcitability as an explanation in at least some cases of synkinesis. Understanding these patterns enhances clinical detection and evaluation and may lead to a better knowledge o f the fundamental pathophysiology of synkinesis and its prevention.