Diagnoses & Conditions Treated // Treatment & Outcomes

Movement Learning Center specializes in the treatment of facial movement disorders due to disruption of the facial nerve.

Treatment is appropriate in Acute, Sub-Acute, and Chronic stages of facial nerve palsy.  It is particularly effective in maximizing the functional results following facial reanimation surgery.

Medical Diagnoses Include:

  •  Bell’s Palsy
  •  Ramsey Hunt Syndrome
  •  Acoustic Neuroma / Vestibular Schwanoma (secondary affects of)
  •  Facial Nerve Schwanoma
  •  Trauma to the facial nerve from
  •        Parotid Tumors
  •        Temporal Bone Fracture
  •        Head Trauma, Brainstem Injury
  •        Complications from Surgical / Medical Care
  •  Post Facial Reanimation Surgery
  •  Congenital Disorders (Mobius syndrome, birth trauma)
  •  Lyme Disease
  •  Guillian Barre
  •  Stroke

Symptoms may include:

  •  Facial paralysis & / or weakness, spasm & twitching.
  •  Abnormal facial movements (synkinesis)
  •  Impaired facial expression
  •  Pain, spasm, twitching, and facial tightness
  •  Inability to close the eye, impaired blink
  •  Abnormal tear production (dry eye, tear over-flow, tearing when eating or exercising)
  •  Noise sensitivity
  •  Difficulties drinking, eating, and swallowing
  •  Dry mouth, pocketing of food
  •  Biting of the lips or cheek
  •  Slurred speech
  •  Facial sagging and asymmetry
  •  Impaired non-verbal communication
  •  Depression and social isolation

We do not treat the following medical conditions:

  • Hemifacial Spasm (studies have shown physical therapy to be of limited benefit in the reduction of hemifacial spasm)
  • Blepherospasm

 


Treatment is appropriate in Acute, Sub-Acute, and Chronic stages of facial nerve palsy and / or facial reanimation surgery.  

Acute Facial Palsy treatment includes:

  • Education & support in the process of facial nerve recovery
  • Training in self care techniques while awaiting return of function:
  •         Movement facilitation strategies to maximize optimal neuro-muscular recovery.
  •         Increase comfort and reduce pain
  •         Ocular Care to prevent corneal damage and maintain healthy vision
  •         Oral Care to maintain optimal oral hygiene and health
  •         Aural Care to assure follow-thru with hearing protection
  •         Encouragement to resume usual social and recreational activities                                                                                                                                                     Note:  Use of electrical stimulation with acute facial nerve palsy is contraindicated.

Acute Palsy Treatment is brief, typically 1-3 clinic sessions, with periodic phone, email, or Skype/video follow ups to assure return of full function; and to monitor for potential problems requiring referral to primary care or medical specialist.


Sub-Acute & Chronic Facial Palsy, and post Surgical Reanimation treatment may include:

  • Education in facial anatomy, physiology, and pathophysiology relative to Pt’s functional status
  • Instruction and Training in Self Recovery Techniques:
  •         Relaxation & somatic awareness specific to the face;
  •         Soft tissue mobilization for reduction of facial myofascial restrictions, spasms, & hypertonus;
  •         Mirror Training for movement re-education and reduction of synkinesis;
  •         Surface EMG Biofeedback for movement re-education and reduction of synkinesis;
  •         Sensorimotor re-education to maximize outcomes of surgical reanimation;
  •         Integration of new facial movements into daily social interactions.
  • Site selection for Botox injections*

Treatment frequency and duration is highly variable and depends upon the client’s specific problems, goals, motivation and consistency of follow thru, and distance they reside from clinic.

Generally, following a comprehensive assessment, including videography, the client will be seen for 2-4 visits in the first month to establish a solid home activity program after which clinic and/or Skype follow-ups will occur on a monthly to quarterly basis for 1-3 years.

*Clients frequently choose to combine fNMR treatment with Botox injections.   MLC will work in close collaboration with the patient’s physician of choice to maximize chemodenervation outcomes. 


Outcomes Include:

  • Increased comfort and normalization of facial tone
  • Improved eye closure
  • Improved oromotor control (speech, fluid and food mgt)
  • Improved facial symmetry, both static and dynamic
  • Congruent and effective facial expression / non-verbal communication
  • Reduced affective issues
  • Resumes prior social and physical activities