Thus, corticobulbar lesions between the brain cortex and the facial bridge and nucleus destroy or reduce the inputs in the ventral division, but the ipsilateral inputs (that is, from the same half of the brain) are kept in the dorsal division. As a result, central facial paralysis is characterized by hemi-paralysis or hemiparesis of the contralateral muscles of the facial expression, but not the forehead muscles
Signs and Symptoms:
Facial paralysis is the paralysis of the inferior half of one of the sides of the face. This condition is frequently provoked by a cerebral vascular accident This condition is normally resultant of a damage in the superior motor neurons of the facial nerve. The facial motor nucleus has dorsal and ventral areas that contain inferior motor neurons, which in turn, power up the superior and inferior half of the face muscles. When the central facial paralysis occurs, corticobulbar lesions in the brain cortex can be found. Due to these lesions, the facial motor nucleus will reduce or destroy the ventral division input. The input in the dorsal region is preserved.
The central facial paralysis is normally characterized by hemi-paralysis or hemiparesis of the contralateral muscles of the facial expression. The forehead muscles remain intact. In addition, the majority of the patients will lose the voluntary control of the facial muscles, however the facial muscles that are involved in the spontaneous emotional expressions often remain intact. Central facial paralysis occurs in hemiplegic patients. These patients not only have dysfunctions in the facial expression as also have communication difficulties. Other functions such as suction, swallowing and speech are also damaged.
Central facial paralysis have often the characteristics of cerebral vascular accident patients. Due to uncrossed ipsilateral and supra nuclear areas, the orbicular frontals and superior eyes movements are often spared. Movements in the affected side of the face when the person expresses emotions can be verified. Damages in the motor via of the central nervous system from the cerebral cortex to the facial nucleuses are found in the bridge. This will lead to a facial weakness that will spare several facial muscles, depending of the type of the paralysis. The discrepancy of the weakness among the superior and inferior facial muscles is due to the bilateral corticonuclear innervation of the superior facial muscles and the contralateral, corticonuclear innervation of the inferior facial nerves.
Facial Paralysis
Exercises for facial paralysis with Hiperboloide
Facial paralysis is a central symptom or find characterized by paralysis or paresis of the inferior half of one of the sides of the face. It is normally resultant of a damage in the superior motor neurons of the facial nerve.
The facial motor nucleus has dorsal and ventral divisions that contain inferior motor neurons, which in turn, power up the superior and inferior half of the face muscles, respectively. The dorsal division receives bilateral inputs of the superior motor neuron (that is both parts of the brain), while the ventral division receives only contralateral inputs (that is the opposite side of the brain).
EXERCISE 1: MASTICATION
Execute this exercise 3 times a day, in the morning, in the afternoon and at night (total: 45 minutes daily), with regular intervals, preferable following the biological clock of the meals, aiming the jaw elevator and depression muscles tone.
Executing these exercises on a daily basis is extremely important for the treatment to be a success, thus, the patient have to be aware that he/she needs to be persevering.
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6 minutes on the paralyzed side.
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3 minutes on the normal side.
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6 minutes alternate bilateral, totalizing 15 minutes.
Picture A
EXERCISE 2: Stimulations of tone in the lips/buccinator orbicular complex and in the pharynx constrictor (Korbitz triple sealing and Fränkel valves):
Put the functional Hiperboloide with the string in the labial fold (buccal vestibule), in the inferior region of the lip (right), use the cheek to contain it (lip orbicular), and traction the muscles up to pull the string. The movement is repeated during 2 minutes. The same process is repeated for the superior region of the lip, pulling it down.
Picture B
EXERCISE 3: BUCCINATOR TONE
Using the Hiperboloide without trespassed string, put it in the labial fold, inferior molar region, press the cheek with simultaneous suction, during 2 minutes. This is repeated in the superior molar region, for the same amount of time.
Picture C
EXERCISE 4: TONGUE STIMULATION
Using the Hiperboloide with trespassed string on both ends, united by a not, put it in the hard palate region, hold it with the tongue, press it and pull the string slowly. This movement is repeated for 2 minutes in order to make noniceptive stimulation in the tongue region affected by the paralysis..
Picture D
Scientific articles published on the efficacy of Hiperboloide in Facial Paralysis treatment:
Revista CEFAC – Speech, Language, Hearing Sciences and Education Journal
2011, Jan-Fev; 13(1):159-164
ALTERAÇÕES SIALOQUÍMICAS E SIALOMÉTRICAS DE PACIENTES COM PARALISIA CEREBRAL: UMA REVISÃO DE LITERATURA
