Neurolysis for Bell’s Palsy?

Question

I had Bell’s palsy and have been workingeith a PT. She has mentioned selective neurectomy. I have synkenisis and can’t smile. Will this help? What are the risks?

Jose Telich, MD · Answer

Dear Aohara thank you for your question.

Synkinesis is a long term complication from facial palsy that requires a real multidisciplinary team in order to control it. Good results can be obtained with physical therapy, specially with something called biofeedback. We usually complement that with the application of botox in certain areas of the face to reduce the abnormal movements and give the face more symmetry at rest. 
Selective neurectomy is a major surgical procedure in which we dissect all the branches of the facial nerve and take out those that create the abnormal movements. It is a procedure that tends to be offered to patients with severe synkinesis, and it should be noted that although it helps in reducing the abnormal movements, it does not take them away completely and PT and botox will still be required after surgery. 
I recommend you meet with a peripheral nerve surgeon with extensive knowledge in facial paralysis, they will be able to give you a better insight into all available options. 
Best of luck.

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