Associated facial contractions after seventh nerve palsy mimicking jaw-winking

A 51-year-old woman who had recovered from Bell's palsy complained of closure of her right eyelids synchronous with chewing. Examination revealed the closure to be synchronous with contraction of the orbicularis oris muscles, not jaw muscles. Other associated facial movements were detected. Electromyography demonstrated that the decrease in size of the palpebral fissure is from contraction of the orbicularis oculi muscles, not inhibition of the levator muscle, proving that this is the effect of aberrant seventh nerve regeneration. This is one of many mass action effects which can occur with seventh nerve regeneration and should not be termed a syndrome.