Current Physiotherapy Approaches in Patients With Facial Palsy

Facial palsy (FP) is the most common acute mononeuropathy involving rapid and unilateral onset of peripheral paresis of the facial nerve for any reason. Peripheral facial paralysis, or Bell’s palsy (BP), a lower motor neuron injury, will be discussed in this chapter. Patients cannot raise their eyebrows or close their eyes, and blinking is affected. BP is one of the most common conditions, and most cases of BP improve within 4–6 months and almost always resolve entirely within 1 year. FP has multiple potential aetiologies. If facial nerve involvement is suspected, the diagnosis is made by clinical examination, imaging, patient complaints, and ear examination. The assessment of facial paralysis has focused on subjective scales rated by the clinician rather than objective outcome measures. The scales analyze parameters such as synkinesis, facial asymmetry, stiffness, and global mobility. Photographic and videographic methods are used in objective evaluations. FP affects the kinetics of facial movement, so videography is reasonable to assess the influence. Early treatment of BP usually results in good outcomes. The treatment plan must be multidisciplinary. Maintenance treatment includes interventions such as eye and mouth care, physiotherapy, botulinum toxin injections, and even acupuncture. The importance of combining rehabilitation with conventional medical treatment for a better BP outcome in all age groups has been shown. Physical therapy approaches aiming to increase muscle strength and various modalities such as electrical stimulation, massage, proprioceptive neuromuscular facilitation (PNF), taping, and mirror exercise that can be given for Bell’s palsy will be discussed.