International Journal For Multidisciplinary Research

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Beyond Recovery: Physiotherapy's Pivotal Role in Treating Synkinesis and Contracture in a Case of Severe Bell's Palsy

Author(s) MITALI JYOTIK BHACHECH
Country India
Abstract Bell's Palsy is an idiopathic condition that results in abrupt, unilateral facial paralysis [1]. In most patients, the recovery period is complete and without consequent [1]. However, a group of patients, and among them, the initial severe cases (House-Brackmann grade IV or above) ones, usually, tend to recover incompletely and develop adverse reactions [1]. The common complications are synkinesis (the involuntary muscle co-contraction, e.g., the eye closing when smiling) and contracture (muscle tightening) [2]. This case report describes the treatment of a 65-year-old male who came with the diagnosis of severe right-sided Bell's Palsy (House-Brackmann VI), later, able to produce synkinesis and contracture of significant degree [9]. Only after the cortisone injection, he had a six-month follow-up wherein he recovered voluntary movements partially [10]. A decision was made to take a multidisciplinary approach with an emphasis on the physiotherapy session [6]. The personalized treatment plan consisted of Neuromuscular Retraining to focus on the isolation of movements, Manual Therapy to elongate contracted muscles, and Biofeedback to facilitate the conscious control of muscles [3,4, 5]. As a matter of fact, six months later, the House-Brackmann score dropped from Grade V to Grade III and the severity of synkinesis and contracture was considerably reduced [10]. In this case, the importance of specialized and patient-specific neuromuscular retraining in the treatment for long-term sequelae of complicated Bell's Palsy is emphasized [11].
Keywords Bell's palsy, Neuromuscular retraining, Biofeedback, House Brackmann grade, Synkinesis, Contracture
Field Medical / Pharmacy
Published In Volume 7, Issue 5, September-October 2025
Published On 2025-10-10
DOI https://doi.org/10.36948/ijfmr.2025.v07i05.57568
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