Selective neurolysis in post-paralytic facial nerve syndrome (PFS)

Post-paralytic facial nerve syndrome (PFS) summarizes specific symptoms that result from an incomplete or poor recovery of the facial nerve after peripheral facial palsy. Selective chemodenervation using botulinum toxin A (Btx A) and mime therapy represent the therapeutic standard for treating PFS. We report on a 35-year-old male who was suffering greatly from unilateral PFS-specific movement disorders, including periorbital contractions and oculofacial synkinesis that did not respond to Btx A administration. We present a surgical alternative to overcome periorbital movement disorders by selective neurolysis and review therapeutic options for this rare syndrome. In conclusion, selective neurolysis appears to be an efficient alternative treatment method of PFS in which the quality of life is severely impacted due to movement disorders and there was no therapeutic benefit from Btx A.

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