Reinnervation by the contralateral facial nerve in patients with peripheral facial palsy

Jordi Casanova-Molla, Luci León, Carlos David Castillo, Josep Valls-Solé
Muscle & Nerve 2011, 44 (6): 923-9

INTRODUCTION: Reinnervation activity is triggered after complete unilateral peripheral facial palsy (PFP).

METHODS: In 27 patients with PFP we recorded electromyographic activity with a concentric needle electrode inserted 1 cm lateral to the oral commissure of the affected side. We applied electrical stimuli to the unaffected (contralateral) facial nerve from the tragus to the mid-lower lip and measured the response latency variability and segmental conduction velocity.

RESULTS: Responses to electrical stimulation of the unaffected facial nerve were found in all patients. Mean conduction velocity was 49.6 ± 6.2 m/s between tragus and oral commissure, and 6.0 ± 1.9 m/s between oral commissure and mid-lower lip. Latency variability was 0.27 ms to facial nerve stimulation and 0.08 ms to oral commissure stimulation.

CONCLUSION: Short distance sprouting of axons that innervate muscle fibers, which originate from the unaffected facial nerve, results in propagation of impulses to muscle fibers in the midline.

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