Selective Neurolysis in Post-Paralytic Facial Nerve Syndrome (PFS)

Post-paralytic facial nerve syndrome (PFS) summarizes specific symptoms that result from an incomplete or poor recovery of the facial nerve after peripheral facial palsy. Selective chemodenervation using botulinum toxin A (Btx A) and mime therapy represent the therapeutic standard for treating PFS....

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Bibliographic Details
Published in:Aesthetic plastic surgery 2014-08, Vol.38 (4), p.742-744
Main Authors: Bran, Gregor M., Lohuis, Peter J. F. M.
Format: Article
Language:English
Subjects:
Adult
Botulinum Toxins, Type A - therapeutic use
Case Report
Contracture - surgery
Facial Paralysis - surgery
Forehead - innervation
Forehead - surgery
Humans
Male
Medicine
Medicine & Public Health
Nerve Block
Neuromuscular Agents - therapeutic use
Oculomotor Muscles - surgery
Otorhinolaryngology
Plastic Surgery
Postoperative Complications - surgery
Quality of Life
Syndrome
Synkinesis - surgery
Treatment Failure
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Summary:Post-paralytic facial nerve syndrome (PFS) summarizes specific symptoms that result from an incomplete or poor recovery of the facial nerve after peripheral facial palsy. Selective chemodenervation using botulinum toxin A (Btx A) and mime therapy represent the therapeutic standard for treating PFS. We report on a 35-year-old male who was suffering greatly from unilateral PFS-specific movement disorders, including periorbital contractions and oculofacial synkinesis that did not respond to Btx A administration. We present a surgical alternative to overcome periorbital movement disorders by selective neurolysis and review therapeutic options for this rare syndrome. In conclusion, selective neurolysis appears to be an efficient alternative treatment method of PFS in which the quality of life is severely impacted due to movement disorders and there was no therapeutic benefit from Btx A. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
ISSN:0364-216X
1432-5241
DOI:10.1007/s00266-014-0346-y