Orbicular synkinesis after facial paralysis: Treatment with botulinum toxin

Abstract

Involuntary lid closure not rarely accompanies aberrant regeneration of nerve fibers after different types of facial paralysis. 23 patients with such synkinesis were treated with botulinum toxin injections into the orbicularis oculi muscle. After periocular injections all patients showed much improvement: a period of, on the average, 13 symptom-free weeks was followed by a period of minimal symptoms. There were only minor complications. Whenever repeated treatment is necessary, botulinum toxin proves to be an effective therapy for involuntary lid closure after defective healing following facial paralysis.

Viral infections of the CNS with special emphasis on herpes simplex infections

“…Although the biological basis of Bell's palsy is so far not completely clear [48], various studies report an association of acute facial palsy with a variety of viruses including herpes simplex virus I, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, Coxsackie viruses, influenza viruses, poliomyelitis viruses and mumps virus; furthermore bacteria, e. g. Mycoplasma pneumoniae, Bartonella henselae, Borrelia burgdorferi spp. etc.…”

“…The disease occurs on either side of the face and approximately 5 % of patients will have a recurrent palsy affecting the same or opposite side. Pregnancy, diabetes mellitus and arterial hypertension have all been associated with an increased incidence of Bell's palsy [13,46,48].…”

Anwendung von Botulinumtoxin beim Blepharospasmus, Spasmus facialis und bei Synkinesien nach Fazialisdefektheilung

“…Der elektromyographische Nachweis der pathologischen synchronen Bewegungen stellt eine verlässliche Methode dar, jedoch lässt sich über die gezielte, geschulte Beobachtung der Bewegungen des Gesichts ebenfalls [14]. Heutzutage stellt Botulinumtoxin zur Behandlung der Synkinesien das Mittel der Wahl dar [15,16]. Nach Aufklärung des Patienten und Festlegung der Dosierungspunkte mithilfe eines Behandlungsbogens, welcher wieder der exakten Dokumentation dient, erfolgt die Applikation der Medikation.…”

Association between Herpes Simplex Type 1 Virus Infection and Bell’s Palsy

“…This disease occurs on either side of the face and approximately 5% of the patients will have a recurrent palsy affecting the same or opposite side. Pregnancy, diabetes mellitus and arterial hypertension have all been associated with an increased incidence of Bell's palsy [8,9,10] . …”