Facial Synkinesis

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Source: NEJM

Original: https://www.nejm.org/doi/full/10.1056/NEJMicm2506222?af=R&rss=currentIssue...

Published: 2026-03-21T11:30:00Z

Facial synkinesis is unwanted involuntary movements of the facial muscles that occur during intentional movements in another part of the face[2]. This disorder occurs in approximately 10 to 20 percent of children and up to 30 percent of adults as a complication of Bell's palsy[5]. Synkinesis develops only if there is damage to the fibers of the facial nerve and their subsequent regeneration[1]. The main mechanism of its formation lies in the defective regeneration of the facial nerve, when the nerve fibers are incorrectly connected, which leads to the inadvertent activation of the facial muscles during attempts to make deliberate movements[3]. Treatment mainly includes botulinum toxin and physiotherapy aimed at neuromuscular training, with the combination of both methods achieving better results than individual treatments[2]. Botulinum toxin provides rapid improvement in symptoms and its effect is reversible within three to four months[2].