The aim of our trip to Philadelphia was to present results of our research to international scientific society and to increase the awareness about the problem and the social impact of long-standing Bell’s palsy complications.
The 9th World Congress for NeuroRehabilitaiton took place at the beautiful Congress venue of Marriott Downtown in Philadelphia on 10-13 May 2016.
The Crystal Touch presentation “The Origin of Synkinesis: the common complication after Bell’s Palsy is in fact, reversible“ was the only scientific research on rehabilitation after Bell’s palsy that was presented during this World Congress. The oral presentation by Alex Pashov has attracted a lot of attention among delegates and the faculty, so the auditorium of 178 seats was nearly full.
The Congress and its main topics
There were about 1500 delegates attending from all over the world. It was a well-organized event, with numerous plenary lectures, oral presentations, poster presentations, workshops and special meetings. The most widely discussed topics were neurorehabilitation after stroke, spinal cord injuries, traumatic brain injuries and multiple sclerosis.
Uncertain prospects for the future research of Bell’s palsy complications
Regretfully, rehabilitation of long-standing Bell’s palsy and its complications seem not to be in the focus of national and international scientific programs. Of course, facial synkinesis, facial asymmetry and contractures of facial muscles are not as formidable as, for example consequences of a stroke, disabilities after spinal cord injuries or steadily deteriorating physical condition resulting from multiple sclerosis.
Yet, seeing our Bell’s palsy patients every day in the clinic, we have learned that for them, Bell’s palsy complications can have a really dramatic effect on their quality of life. Inability to smile normally, asymmetric facial movements during speech and emotions, permanent facial pains or constant tearing of the affected eye, often lead to loss of self-esteem, loss of self-confidence and even may result in a career change or in social isolation of such patient.
Fundamental research of long-standing Bell’s palsy complications is left to the goodwill of a few enthusiasts
From various conversations with delegates and members of Scientific Committee before and after the presentation we could conclude that neurorehabilitation after long-standing facial palsy (and Bell’s palsy in particular) is not likely to receive much attention or funding for scientific research in the near future. The reasons are simple. Governments do not see complications of Bell’s palsy as a potential threat to public health.Private companies invest available research funds into more acute and urgent areas, where marketable products are in high demand due to potential direct threat to health and lives from the “heavy-weights” of neurological diseases and disorders.
This essentially means that at the moment Crystal Touch clinic remains one of very few institutions in the world that focus exclusively on research of Bell’s palsy, its long-standing complications and on developing new effective methods of recovery.
Is now the time for a paradigm shift?
The main message of our presentation at Philadelphia World Congress for NeuroRehabilitaiton was: Synkinesis is not a result of aberrant nerve regeneration, ephaptic transmission or nuclear hyper-excitability. Facial synkinesis is a CONDITIONED REFLEX. As any conditioned reflex, synkinesis can be reversed by negative feedback.
In the medical and rehabilitation community, it is now the time for a paradigm shift. From “Learn to live with it” to “Together we can work on it, it is reversible”. For the estimated 12 million long-term Bell’s palsy sufferers in the world, this would mean a new hope – after all those years to finally bring back their long-lost Smiles.
The Origin of Synkinesis – Abstract
This is the abstract of the scientific research of Crystal Touch Bell’s palsy clinic on The Origin of Synkinesis.
Contact person & Presenting Author: Mr Alex PASHOV, Crystal Touch Bell’s palsy clinic
Session type: Peripheral Neuropathy and Neuromuscular Disease
Topic: Basic Science/Regenerative Therapy
Presentation preference: Oral presentation
Keywords: Bell’s palsy, Bell’s palsy sequelae, treatment of synkinesis, synkinesis, facial asymmetry
Abstract title
THE ORIGIN OF SYNKINESIS: THE MOST COMMON COMPLICATION OF BELL’S PALSY IS IN FACT REVERSIBLE
Aims
To analyze inconsistencies in the existing theories of synkinesis after Bell’s palsy: aberrant regeneration, ephaptic transmission and nuclear hyperexitability. Using the new quantitative instrumental method of Synkinetic Correlation (SC), to research, define and substantiate the probable cause of synkinesis after long-standing Bell’s palsy. To investigate the resulting possibility to reverse facial synkinesis regardless of the time passed since the onset.
Method
For 40 Bell’s palsy patients (32 female and 8 male, age 18-78, time since the onset >1 year) we measured oral-ocular and ocular-oral synkinesis, using Synkinetic Correlation method. First measurements were made during intake-meetings and final measurements – after 6 to 9 months of Neuro-Proprioceptive Rehabilitation (NPR) program. Results were analyzed from the perspective of existing theories of facial synkinesis.
Results
Synkinetic Correlation between “muscles-Masters” and “muscles-Slaves” varied from 0.5 to 1.3. After rehabilitation programs, SC in 39 patients reduced on average to 0.2-0.6. One patient (aged 78) showed no change. Existing theories cannot explain Synkinetic Correlation >1, nor why after rehabilitation program, which did not include medications, Botox injections or surgery, the intensity of synkinesis showed an objectively measurable and lasting reduction.
Conclusions
The cause of facial synkinesis is the forming of a pathological mimetic pattern (PMP) in the volitional mimetic center of the brain. During early stages of Bell’s palsy patient exerts repeated mental efforts of high intensity, trying to produce facial movements. Due to high-intensity, those efforts cannot be finely differentiated between proper facial muscles. This leads to a “mass-movement” pattern of the resulting efferent signals. During long recovery period this pattern transforms into a conditioned reflex by constant repetition. When the regenerating nerve fibers finally reconnect to their facial muscles, PMP manifests itself in synkinesis. As any conditioned reflex, facial synkinesis can therefore be reversed by negative feedback.
