Electrical stimulation is sometimes given to patients with facial palsy.
The facial nerve normally emits electrical impulses to give muscles their tone and shape. When the facial nerve is damaged the muscle no longer receives these messages and as a result the muscles become weak and floppy. External electrical stimulation can try and mimic these electrical impulses and help restore muscle tone.
It should only be used under the guidance of a therapist with specialist training in the management of facial palsy. Use of electrical stimulation should be closely monitored by the therapist. Patients should not try this treatment without supervision as there are some indications that it may cause harm when used incorrectly.
If there is every possibility that the nerve will recover spontaneously, albeit incompletely, then it may be better to let nature take its course. The person should massage their face twice daily which helps to maintain circulation and mobility of the facial muscles and also maintains the feeling of movement (which cannot be gained via electrical stimulation). The main focus in the early weeks of recovery is protecting the eye and facial massage.
As the facial nerve recovers it will start to fire electrical impulses back into the facial muscles and you will see the muscle tone return. If you continue to use external electrical stimulation at this point the muscles will become over stimulated. The result is short, tight, stiff muscles that cannot move. Tight muscles become painful and may spasm or twitch. It may also cause unwanted movement in the muscles on the affected side of your face, (synkinesis).
There is one group of patients who may benefit from electrical stimulation and who are not at risk of developing muscle tightness or synkinesis. These patients have complete loss of their facial nerve which may have been cut or irrevocably damaged by disease. In some cases the person may have been born without a facial nerve. The presence of the nerve is not required for external electrical stimulation to be used. It is the muscles which are stimulated not the nerve. The benefits are short lived so that once you stop using the electrical stimulation the muscle will lose its tone.
The key message is that this treatment should only be given under strict guidance from a specially trained therapist. It is not necessarily the optimum treatment of choice and the majority of people often make a good recovery with other forms of more evidenced based therapy.
Last reviewed: 27-04-2019 || Next review due: 27-04-2022