Abstract

OBJECTIVE: In this study, the relationship between synkinesis that developed after idiopathic or traumatic peripheral facial nerve palsy and electrophysiological findings was investigated.

METHODS: This cross sectional retrospective study was conducted with a total of 131 patients (61 males, 70 females; mean age: 41.9±17.7 years; range 11 to 80 years) between Ocak 2016 and Nisan 2022. The study included 35 patients who applied within the first 10 days after peripheral facial paralysis and were followed up regularly for one year and 96 patients who presented for synkinesia in the last five years. Electrophysiological examinations of all patients consisted of direct stimulation of the facial nerve, blink reflex responses, and needle electromyography (EMG). The severity of nerve fiber degeneration was determined by direct stimulation of the facial nerve, recording of different facial muscles, and needle EMG examinations of these muscles. Synkinesia was detected via reflex responses and needle EMG.

RESULTS: In our study, it was determined that synkinesis started from the first month in six patients and from the second month in seven patients with the help of reflex responses. The most common symptoms in patients were “blinking with the voluntary contraction of the mouth muscles” and “twitching of the mouth muscles with the voluntary closure of the eyes.” In addition, synkinesis was detected in three patients with chewing movement and in one patient with swallowing. A significant clinical correlation was observed between the severity of facial palsy and the severity of synkinesis. There was also a significant correlation between the severity of synkinesis and needle EMG findings.

CONCLUSION: It was concluded that most of the peripheral facial paralysis cases included in the study developed synkinesia of varying severity and that this synkinesis could be demonstrated in the first months via trigeminal-facial brainstem reflex examinations.