We have received the following question: “I was diagnosed with Bell’s palsy 11 months ago. My cheek on my affected side is not as full as the other side and I do not have my full smile back. Has my cheek atrophied? And is it possible that the nerves are still healing, or is my issue synkinesis? Thank you for your help.”
What is atonicity and how different is it from atrophy?
As we have explained in our previous post, atrophy of facial muscles after long-standing facial palsy does not occur.
Instead, facial muscles may suffer from, what is called, atonicity – a reduced tone of facial muscles. While the facial nerve is still recovering, the intensity of signals that arrive at the facial muscles is not that strong. From less work, so to say, less use, they are experiencing less tone. It is atonicity. Not atrophy.
As an analogy, consider a broken leg. If you break your leg and do not use it for some time, the muscles on that leg will become smaller and less strong. This is also atonicity – the loss of tone.
Can it be reversed?
Yes, atonicity is a reversible phenomenon, and it is something that you should not be desperate about. As long as your facial nerve is still recovering, atonicity may be present. The facial nerve may continue to recover for a long time, for several years.
Of course, the tempo of recovery will continue to decrease, until at some point, after a few years, it will reach a certain stable condition. It will stay there unless you do something. That is actually one of the modalities that we are doing with our patients – micro-stimulation of the nerve. Micro-stimulation does not involve any electroshocks used in Electric Stimulation, do not confuse it with that.
Thanks to the micro-stimulation, we have seen, in a number of our patients, reinstatement of regeneration of the facial nerve. Even after a few years, several years past the onset. The results of the Nerve Conduction Study that we perform during the rehabilitation show improvements in the nerve conductivity at the end of the rehabilitation program of these patients.
