Can Facial Nerve Issues from Childhood Be Treated in Adulthood?

Facial nerve

I had facial nerve paralysis when I was in elementary school, and I underwent electrotherapy for treatment.
My parents said it was cured, but now at 22 years old, I notice that when I blink in front of a mirror or on video, the corner of my mouth moves as well.
Doctor, is there still hope for recovery after all this time?

John Wick, 20~29 year old female. Ask Date: 2023/08/06

Dr. Jiang Junyi reply Neurology

Dear Mr.
John Wick,
You mentioned that "the corners of the mouth move when blinking," which may indicate facial nerve damage and the subsequent misinnervation of muscles during nerve regeneration.
Additionally, some metabolic disorders, such as hyperthyroidism and electrolyte imbalances, can also present with similar symptoms.
The movement of the corners of the mouth is controlled by the facial nerve; if there is persistent twitching, the physician will first carefully observe the patient's facial muscles.
If other muscles are also experiencing spasms, it may indicate facial nerve spasms.

It is advisable to reduce the intake of caffeine, which can stimulate the nervous system.
Supplementing with vitamin B and ensuring adequate hydration, along with sufficient rest, can help enhance self-healing capabilities.
Some patients may benefit from muscle relaxants, while more severe cases might require botulinum toxin injections to alleviate symptoms.

I recommend visiting a neurology clinic for further examination and follow-up.
Wishing you good health, safety, and happiness.
Best regards,
Dr.
Jiang Junyi
Taoyuan Medical Center

Reply Date: 2023/08/06

More Info

Facial nerve issues, such as those resulting from Bell's palsy or other forms of facial nerve paralysis, can indeed have lasting effects that may persist into adulthood. The condition you described, where your mouth moves when you blink, is known as "synkinesis." This is a common phenomenon that can occur after facial nerve injury, where the recovery of the facial nerve leads to unintended movements in other areas of the face.

In your case, since you experienced facial nerve paralysis during childhood and have noticed these symptoms at the age of 22, it is important to understand that while some recovery may occur naturally over time, certain symptoms like synkinesis may not resolve without intervention.

Treatment Options
1. Physical Therapy: Facial exercises and physical therapy can be beneficial in improving muscle control and coordination. A specialized therapist can guide you through exercises designed to strengthen the facial muscles and improve their function.

2. Botulinum Toxin Injections: In some cases, botulinum toxin (commonly known as Botox) can be used to help manage synkinesis. By injecting small amounts of the toxin into the overactive muscles, it can help reduce the involuntary movements associated with blinking and smiling.

3. Surgery: In rare cases, surgical options may be considered, especially if the synkinesis is severe and significantly impacts quality of life. Surgical interventions can involve procedures to re-establish normal muscle function or to relieve tension in the affected muscles.

4. Psychological Support: Living with facial nerve issues can sometimes lead to emotional distress or self-esteem issues. Counseling or support groups can be helpful in addressing these feelings and improving overall mental health.

Prognosis
The prognosis for individuals with facial nerve issues varies widely. Some people may experience significant improvement with treatment, while others may have persistent symptoms. Early intervention is often key to achieving the best outcomes. Since you are now an adult, it is advisable to seek evaluation from a specialist, such as a neurologist or a facial plastic surgeon, who has experience with facial nerve disorders.

Conclusion
In summary, while the effects of childhood facial nerve issues can persist into adulthood, there are treatment options available that may help improve your symptoms. It is essential to consult with a healthcare professional who can assess your specific situation and recommend an appropriate treatment plan. With the right approach, many individuals find relief from their symptoms and improve their quality of life. Don't hesitate to seek help; addressing these concerns can lead to significant improvements in both function and self-esteem.

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