Peripheral facial palsy affects 15 to 40 people per 100,000 inhabitants and induces important functional and social repercussions. Synkinesis is a frequent after-effect of facial palsy recovery, consisting of involuntary facial spasms that disturb the gestural harmony and can go as far as a painful hypertonic spasm. More than 55% of patients recovering from facial palsy will develop transient or permanent synkinesis. These facial hypertonias have two main causes: imperfect axonal regeneration, which is all the more important as the damage is proximal, and hyperexcitability of the facial nerve nucleus due to a lack of central control. Management is therefore essential for the functional restoration of the face, especially since synkinesis do not evolve spontaneously. The main treatments are currently botulinum toxin injection, acting on the motor plate, and functional rehabilitation, consisting on local muscle relaxation and central motor control work. In recent years, therapies based on biofeedback and acting on central motor control have shown interesting results, and technological advances in virtual reality have made it possible to deepen this treatment in patients suffering from stroke, limb trauma or Parkinson's disease. In this project, the investigators evaluate the contribution of virtual reality to the management of facial palsy, and hypothesize that self-rehabilitation using this technology will improve motor control of the skin muscles and reduce complications related to their hypertonia such as synkinesis.
Patient with recent onset peripheral facial palsy (≤ 12 months).
Patient with peripheral facial palsy of grade ≥ III on the House & Brackmann score
Patient of legal age (≥ 18 years)
Patient with appropriate information and informed consent
Patient with central facial palsy
Patient with peripheral facial palsy of > 12 months onset
Patient with peripheral facial palsy of grade < III House & Brackmann score
Patient who has previously undergone palliative surgery
Parallel
massages
Other interventionThe experimental rehabilitation protocol includes massages
motor stimulation and stretching
Other interventionmotor stimulation and stretching
virtual reality
Other interventionPatient watches an avatar of his face performing different movements on a screen, and will have to imagine performing these movements without actually doing them.
variation of number of involuntary facial spasm between both groups of patients
variation of synkinesis in patients with recent onset (≤ 12 months) peripheral facial palsy compared with the conventional rehabilitation protocol
Click on the lead sponsor to view all of their trials.
Centre Hospitalier Universitaire, Amiens
Lead sponsor
University Hospital, Rouen
Collaborator
