Botox for facial paralysis and synkinesis

[amymeri]

Hi Everyone

I go to see Dr. Hadlock in Boston next week.  I have facial paralysis with hypertonus in my cheek and lower jaw that causes an unattractive and annoyingly constant sneer.  I am hoping that with exercises and perhaps botox my appearance and the ability to close my mouth will improve.

Has anyone used Botox for their synkinesis and if so what was your experience like?  I have been on bellspalsy.ws to get some feedback, but would love to hear about it from an ANer.  My facial nerve survived the surgery intact but went out on me two days later and its been 7 months now...I am hoping for more recovery.

[jan pentecost]

I haven't been to this site for too long. I had surgery on May 3, 2005.....I am afflicted with synkinesis...if the left side of my mouth turns up, my left eye closes...if I close my left eye, the left side of my mouth pulls up. My doc suggested Botox but I have been relunctant....I hated the facial paralysis so much that I am afraid the Botox will relax everything too much and I'll look like I have had a stroke again.

I am 54 and have the typical  and gradual loss of toneness in my face (my right side)due to age....altho I still look younger than my years.....but I constantly have this hypertoness to the left side and sometimes my face feels....tired from the muscles always working......
Any suggestions if anyone else has experienced this??

After 20 months, I still have the metallic taste in my mouth.....and eat with a napkin over my mouth because the left side doesn't close enough to keep all the food in.....not really noticeable to most but definately to me!!!
I still use a straw on occasion as when I am tired, the liquids can find their escape out the left side.

Otherwise...I have been just spiffy with my recovery.....my doc did tell me that the quality of life would not be improved as a result of this surgery and I am grateful for his honest statement...
Oh.....my facial paralysis has not resolved 100% by any means. I still cannot raise my eyebrow....at all....or flare my left nostril.......after surgery, that was a goal of mine that I haven't achieved yet.

God bless you all


Thanks,

jan

[amymeri]

How long did your recovery to this point take?  I am 9 months out.

I can't close my mouth on the right at all and it looks really ugly. I have lots of hypertonus in my cheek as well and numbness on the right side, so I can really relate to your descriptions!

I went to see Dr. Hadlock and got botox shots in 3 places:  next to my eye, on my chin and in my neck.  It was just a week ago and it takes a week or so to see changes and several weeks to reach the zenith.  I have noticed a few changes already.  I can smile and my eye closes much less, I can close my eye and my cheek and lip don't move nearly as much, I can turn my head without my face scrunching up and my face feels a little more relaxed. 

It isn't dramatic by any means, probably only I can tell at this point.  But I am hoping the results will continue to improve over the next weeks.  I think Botox is a trial and error system and I am lucky to have a doctor that is an expert in the treatment of facial paralysis.

I willl let you know what happens.

If you have any questions, please feel free to ask of PM me!

Amy

[daylight]

I just posted regarding hemifacial spasms. The online support group for that also suggests botox use.  Many of the posters are against it's use as it makes their face droop.  Paralyzing your musles even more sounds a little strange. I would do some serious research first. And if you do go that route, it's effects should only last about 6 months anyway.
Sue B.

[amymeri]

If you get botox it much be done by someone very experienced.  It is true that if you inject the cheek or nasolabial folds you may have some drooping.  Since my problem is hypertonus (exaggerated contraction of the muscle) and so I have no drooping but the opposite problem...a scrunched up face...the judicious use of botox relaxes the chronically contracted muscles and that allows other muscles to do their job.

Additionally, if you have synkinesis (abnormal movements) botox can prevent unwanted movements while you learn to move your face correctly.

Finally, botox can be used to make the face more symmetrical:  to even out eyebrows for instance. 

If you feel you may benefit from botox you should seek out a doctor with experience treating facial paralysis and residuals.  It can help but it isn't a miracle.  It has helped my synkinesis quite a bit.

[Gennysmom]

Amymeri,

Interesting, I've been reading the Bell's Palsy pages too, I have all those symptoms.  I see my doctor again in 3 months and he spoke of doing Botox as well...but until then, I'm trying the massaging the cheek trigger points...when they described putting your opposite thumb in your mouth and pinching your cheek and finding the painful spot...I had one of those!  I have hypertonus as well, and it seems that can be the main culprit of the synkenisis.    I think massaging is helping a lot.  I also cannot flare my nostril, curl my tongue, whistle, stick my bottom lip out and my eyelid is looking rather crepe-y for a 41 year old.  When I nap I find my face contorts up into a ball and I have to consciously tell it to relax the muscles.  What a long weird process this all is!

[amymeri]

A couple stretches that have helped my hypertonus

put your thumb inside your affected cheek and your fingers high on your cheek bone and slowly drag down, with firm pressure, towards the corner of your mouth.  Pause and hold any knotted areas.  I do this stretch all over my cheek from the lower jaw to the area by my nose.

Then taking your first two fingers place them by the side of your nose below your eye.  Slowly drag them down the juncture of your cheek and nose until you get to the nostril and then sweep the fingers out along the cheekbone about 1 inch.

Roll the eyebrow ridge area like you are rolling a little piece of dough between your fingers.  Work all along the brow.

Usually I do 8 sets of each, 3x a day.

I also try to NEVER clench my teeth (which I do unconsciously) and try to relax my face as often as I can remember.

I am no expert so I recommend you check with an authoritative source and your doctor before attempting.

[klangel]

i just had botox injections yesterday to help relieve the excruciating facial pain since my surgery in 2005. i have already lost 5 teeth and now am experiencing significant bone loss in my jaw due to the constant tightness and clenching of my left side. its good to read that it has worked for some of you. the doc said it would kick in in about 2 weeks and we would know if it was going to help. in the meantime my face just keeps getting more and more crooked. ha almost as distressing as the pain (vanity) but not quite. if this works it could be one of many issues i can cross off the list! heres hoping!