M.  Ciriello,Mariaconsiglia Calabrese,
The Role of Rehabilitation in Peripheral Paralysis of the Facial Nerve: A Case Report of a Patient Treated with a Neuro-Cognitive Approach
Global Clinical Case Reports
2020

http://dx.doi.org/10.31487/j.GCCR.2020.01.02
https://www.sciencerepository.org/the-role-of-rehabilitation-in-peripheral-paralysis-of-the-facial-nerve_GCCR-2020-1-102 
Abstract: Peripheral paralysis of the facial nerve is a pathology that, although not involves any risks for the patient's
life, significantly affects not only motor, but also communicative, psychological, and social aspects, having
an important impact on the quality of life. The most widely used therapeutic proposals do not always respond
to the need to intervene on all the functional components related to the facial nerve, but to prevent and treat
complications. The neuro-cognitive proposal, although not found in the literature or in the biomedical
databases, takes into account the motor, communicative, verbal and non-verbal functions related to facial
mimic, as well as the cognitive-exploratory function of some districts of the face and intervenes following
the phases of nervous recovery limiting an abnormal reinnervation. The case reported concerns a patient
with a paralysis caused by surgical removal of acoustic neuroma (vestibular schwannoma), with grade III
on the House-Brackmann scale, seems to be an example of how an approach of this type is constructed in
such a way as to follow the various phases of recovery of the peripheral nerve injury, promoting the recovery
of the various functions related to the facial. The patient evaluated with the Sunnybrook Facial Grading
System (SFGS) went from 21/100 to 92/100 and did not develop synkinesias after about 5 months of
treatment. The neuro-cognitive approach would seem to progressively improve the quality of movement.
Moreover, being selective with respect to muscle recruitment and inserted in a functional perspective that
respects recovery times, it would seem to limit the appearance of pathological sequelae such as synkinesias
and spasms.Keywords: Nerve, House-Brackmann scale, SFGS