AN side eye closes when I eat..... what now ??

[marg]

Okay,
   I am now almost 7 months post surgery and have gone from an eye (on the AN side) that wouldn't close without great concentration -to an eye that I can close easily (except it still doesn't close all the way when I blink) and now in the last couple of days it closes when I chew.... and it is watering llike crazy.  What is the deal with this?  Boy, never a dull moment.  Anybody else experience this? 
     By the way, anyone else have facial paralysis and then have it totally resolve over time -so the face 'goes back to normal' (pre-surgery)?  Just wondering if this adventure ever ends.
     
     I always admired my nephew's dimple in his chin....now I have one...but it is off center and looks odd .  Teaching in a classroom these facial changes seem to happen at the most inconvenient times.  Nothing like standing up teaching and suddenly have your face pull or a dimple suddenly appear in the chin.  .
     Thanks for listening.... I have broncitus and a sinus infection and that probably is not helping the healing process at all.  Somebody stop the merry-go- round and let me off the ride  
Margaret

[OTO]

marg,

My eye waters when I eat.  At my regular eye check up in Oct (my surgery was in May), the opthamologist said is the facial nerve regenerating fibers that were damaged.   He laughed and said its good because it help keep the eye moist....   I told him yeah, but I chewing and tears are running down my cheek from one side only....   I have the hamburger in one hand and the napkin dabbing my eye in the other, I look crazy.

Because of the slight facial numbness which is almost back to normal, the sinus on that side always feel clogged.   When I was first post-op, I use to wear Breathe Right strips across my nose, which made the sinus open up.   Try that... it might help... 

[4cm in Pacific Northwest]

Quoting this booklet put out by our ANA – available here

https://secure.baxinternet.com/~anausa/for_sale.html

The Facial Nerve and Acoustic Neuroma: Possible Damage and Rehabilitation (AN4)
Tips and information for patients who have facial weakness or paralysis after treatment for acoustic neuroma. Includes an explanation of the facial grading system and some exercises that can be performed at home to improve facial tone.

Price: $2.00

Page 2

“If the facial nerve is only mildly damaged, the “core� (axon) of the nerve itself will generate slowly (approximately one inch per month) all the way back to the branches in the face. But even with only mild damage, there can be some misdirection of fibers. The regenerating fiber can grow down the wrong nerve channel, leaving a result like crossed wires. This “new connection� can cause inappropriate movement, also called synkinesis, such as the eye on the affected side blinking or tearing when one chews.�

Synkinesis definitions

http://www.enotes.com/neurological-disorders-encyclopedia/facial-synkinesis

http://www.answers.com/topic/facial-synkinesis?cat=health

British Bells Palsy Organization pamphlets on-line
http://bellspalsy.org.uk/leaflets.htm


Quote from ANA’s
The Facial Nerve and Acoustic Neuroma: Possible Damage and Rehabilitation (AN4)

Pages 6-7
Neuromuscular Re-Education Techniques
Presently, several therapists in the United States specialize in neuromuscular re-education techniques which can help improve facial expressions and symmetry once movement begins to return. The principle underlying the therapy is that the plasticity of the brain allows fir retraining abnormalities that result damaged facial nerve. This is especially helpful in cases where incomplete recovery has resulted in abnormal facial movement patterns known as synkinesis… 
Page 7
…With practice, some acoustic neuroma “alumni� with little, weak or uncoordinated facial movement on the affected side, have retrained existing nerve fibers resulting in additional or improved function…

Marg,

I am suggesting that you:
  *get a copy of the ANA booklet from the link above sent to you
* You make an appointment for physiotherapy (your insurance may require a referral from a physician first)
* You are prompt on getting assistance with this and not put it off

Questions to ask before get facial treatment (physiotherapy included)
http://nervous-system.emedtv.com/bell's-palsy/bell's-palsy-treatment-p2.html

I hope some of the above information is helpful and I have not overwhelmed you. 

Hugs,

4

[lori67]

Marg, have you gone to PT for the facial issues?  I've been going for a few months now.  She couldn't really do much before I started to have some movement, but right about 7 or 8 months, I started to get some.  I'm not sure if you are experiencing synkinesis, but it might not hurt to have a PT check it out.  It's much easier to try to correct if you catch it early. 

Currently, I can't blink, but you do see a little flutter of movement in my eyelid when i try - unfortunately, due to the synkinesis, my upper lip and cheek on that side move when I try to blink.  It's pretty minor now and chances are only my PT and I notice it, but we are working on correcting "the wiring" so the right parts move when they are supposed to.  Otherwise, if we leave it this way, eventually I will look like I'm snarling when i try to blink.  I don't really want that to happen!

If areas of your face like dimples in your chin, laugh lines or the little indent below your nose start to look like they are pulling to one side, it means the muscles on that side are getting stronger than they should be.  It could either be on your good side, compensating for the lack of muscle tone on your bad side, or it can be on your bad side, meaning the wrong muscles may be getting activated by the nerve, causing the assymetry.

Hope that didn't sound too confusing.   I think I may have confused myself!  If you figure out where the "stop" button is for this merry-go-round, let me know!


Lori

[pattibobatti]

Hi Girls,

I had the dimple also, just to the left of my chin.  A muscle that was over working caused the dimple.  Sometimes dimples are cute!!  But it just added to the "there is something wrong with her" look.  Just last month my doctor injected the chin with botox and it is totally gone.... YEAH!!

It will last for about three months and I will need another shot.


Sometimes, things can be fixed so easy!

Patti

[marg]

Thank you all.  I appreciate all the info.  I think I will check out the Physiotherapy thing as soon as I feel better (now on my 2nd batch of antibiotics ) and Christmas is over.  My neurosurgeon said that things should resolve on their own..... but I think I'm ready for a second opinion on the facial paralysis with someone who works with it.  I need someone in southwest Washington - or the Portland  Oregon area.  Anybody have someone they would recommend?
Thanks a lot.
Margaret
   

[4cm in Pacific Northwest]

Start here
http://www.ohsu.edu/health/meet-our-staff/doctors/doctor.cfm?id=11302

He may have physiotherapists who work with him.

Here is an article that explains “facial retraining specialist�

http://healthlink.mcw.edu/article/1031002821.html

My own PCP suggests if I have delays in palsy resolve- we examine acupuncture.    However I feel I am having resolve along the schedule predicted by my surgeon – so I will wait it out unless I get synkinesis- then maybe I will explore that alternate medicine practice.


Here is an interesting acupuncture article I came across on synkinesis treatment.
http://www.a1articles.com/article_152503_17.html

This link explains Neuromuscular Facial Retraining (however not in the PNW)
http://www.aurorahealthcare.org/services/rehab/services/facialrehabilitation.asp

This physiotherapists is on the American Academy of Balance medicine website
http://www.americanacademyofbalancemedicine.org/index.php/vestibular_meetings...
Indicated this person gave a presentation at the Vestibular Meetings 2007
Neuromuscular Facial Retraining
Oct. 5–6, 2007
Portland, OR
Instructor: Gaye W. Cronin, OTD, OTR
(800) 487-6530; www.educationresourcesinc.com

It might be worth just calling her to see if she knows of some reputable colleagues in your area (let all of us PNW’ers know if she does!)

Even a call to the 'vestibular lab' at Good Sam Hospital in Portland might have some folks in-the-know who can also point you to a “facial� person.
http://www.legacyhealth.org/body.cfm?id=1902

My experience, in our region, is that the doctors do not network that well with each other … but the physiotherapists’ sure do.

Good luck … and keep us posted.

Cheers,

4 

P.S.  I was wide awake at 3 am - again!   

[lori67]

Another good site for information is www.bellspalsy.ns - some of it doesn't apply to us, but there are some good exercises on there.

Also, if you're looking for a PT well trained in facial issues, there is a list.  There's a whole list of options on the left side for different information.

Would you look at that, I'm almost as knowledgeable as "4"!! 

Lori

[marg]

Thanks Lori,  I will check it out 
Margaret

[4cm in Pacific Northwest]

Hey Lori,

I could not get that link to display
http://www.bellspalsy.ns/ 

 Ã¢â‚¬â€œ I am wondering of it is supposed to be “dot-orgâ€? at the end of bellspalsy instead of “nsâ€? or  “dotâ€? something else…

Did you mean this one? (dot- org)
http://www.bellspalsy.org/

Or this “dot-net�?
http://www.bellspalsy.net/
(which almost seems like a tabloid  )

Or this “dot-ca� ?
http://www.bellspalsy.ca/
(which almost always means a Canadian address)

Or this “dot ms�?
http://www.bellspalsy.ws/
Which has a good facial retraining link
http://www.bellspalsy.ws/retrain.htm
(I have no idea was dot “msâ€? stands for  )
… but this one seemed to match more what you said,
“ but there are some good exercises on there.�
I am not that knowledgeable -I only just start this “homeschooled Neurotology 101 crash summer courseâ€?    back in May – when I was first diagnosed. and  I had to figure out how to spell (heavens  knows pronounce ) words like “vestibular schwannomaâ€?, “otolaryngologyâ€?, “Retrosigmoidâ€? and “sub occipitalâ€? – which all was goobely goop     to me …


I did not find a bellspalsy “dot comâ€? … they must have financially had a crash, like the rest of us, back in the late ‘90’s LOL   

Anyway it must be Bellspalsy something or other – I wish I did not have that diagnoses too … but hey this AN journey has been quite THE education. Nothing like having a personal problem to motivate one to get more educated… gee maybe I should have taken Latin and Greek in college. LOL 

Well we may not come out of this any cuter- but we will all come out smarter. 

Your research partner,

4

[Cheryl R]

         The website is www.bellspalsy.ws                     It is the one I mention frequently as Jackie Diels has the  info on there.                       
                                                       Cheryl R.
                                     

[lori67]

Thanks Cheryl.  Apparently my fingers are suffering from dyslexia.

I should have known - try to keep up with "4" and I get shot down....     Oh well, I was close!

[4cm in Pacific Northwest]

Uh oh

Oh Lori I was not shooting you down- not at all. Sometimes that is the problem with the written word is we cannot always understand the intentions or the voice intonations of the writer … and often misunderstandings happen via on-line dialogues.

Gee we all make typos...

I really appreciated the link you shared particularly being that my face often looks like the little face icon you used. 

On that link, you shared, is this great webpage.
http://www.bellspalsy.ws/retrain6.htm
Excellent information on this site you shared!

No malice intended here … and the last thing I would ever want you to feel is shot down. So sorry.

Can you forgive me?

4

[marg]

What a great site !   I printed off the info. and facial exercizes.  Still plan to go see someone...but at least have some info. to start on.
Thanks again,
Margaret

[lori67]

Oh, I was just teasing you "4"!  It takes much more than that to offend me!  And yes, i thought the little half-smiley was very appropriate!  Looks like me too!

Lori