Facial Palsy Rehab

A woman with brown hair and a blue sweater sitting on a bench in a park with green grass and trees in the background, smiling at the camera.

Facial palsy rehabilitation can help improve your face coordination and expression, if you have face muscle weakness or synkinesis due to facial nerve dysfunction. Our experienced therapists provide a comprehensive evaluation and will guide you in your recovery.

You will gain a better understanding of how your facial nerve and muscles work, why you are having difficulties, and practical strategies to manage your symptoms. Rehabilitation also involves soft tissue and muscle work to help normalize tone and retrain imbalanced movements.

Our primary clinic is located at Toronto General Hospital with a satellite clinic at Bridgepoint Hospital, and virtual care available throughout Ontario.

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What is facial palsy rehabilitation?

Facial palsy rehabilitation is a non-surgical therapy that helps you relearn to move your face muscles in a natural way after an injury to the facial nerve. It is an individualized treatment program to improve face movement, coordination, and expression. This therapy is also referred to as facial nerve rehab or facial neuromuscular retraining.

What causes facial palsy?

Facial nerve palsy is caused by inflammation or damage to the nerve that controls the muscles of the face (the facial nerve or cranial nerve VII). This results in sudden weakness and inability to control one side of your face. Paralysis of the face muscles can cause drooping of your eyebrow and mouth, and difficulty closing your eye. You may also experience excessive tearing or dryness of one eye, hypersensitivity to sound, problems with taste, or pain/abnormal sensations in your face. Facial paralysis can cause difficulty eating, drinking, or speaking, and problems communicating with facial expressions.

The most common cause of facial paralysis is Bell’s Palsy - this causes weakness on one side of the face that is usually temporary for most people. Ramsay Hunt syndrome also causes face muscle weakness, along with vestibular symptoms. Vestibular schwannoma (acoustic neuroma) can cause facial weakness, because the vestibular nerve and facial nerve are located close together. Other causes include Lyme disease, facial schwannomas, parotid tumors, pregnancy (3rd trimester), trauma, congenital or post surgery/radiation.

What is synkinesis?

Facial palsy rehabilitation can help improve synkinesis, which is when delayed facial nerve recovery results in abnormal and unwanted movements.

Signs of synkinesis may include:

  • Tightness in face muscles

  • Neck muscle tightness with face movements

  • Mouth movement like smiling or chewing causes your eye to narrow or close

  • Closing your eye causes your mouth to move or neck to tighten

Conditions we can help

  • Facial weakness due to facial nerve schwannoma

  • Facial weakness due to trauma, surgery or radiation

  • Synkinesis

  • Bell’s Palsy

  • Ramsay Hunt syndrome


  • Facial weakness due to vestibular schwannoma/acoustic neuroma

What happens in facial palsy rehabilitation?

A female healthcare professional with dark hair and a green shirt, wearing a white lab coat, talking to a patient with reddish-brown hair in a gray sweater, holding a tablet device, near a window.

Assessment involves:

  • Evaluating facial muscle function, your face movements and expressions

  • Photos and videos to track your recovery

  • Intra-oral Exam

  • Understanding your symptoms and how they are affecting you

Treatment depends on the cause of your facial palsy, how long you have had it, and the type of damage to your facial nerve. Treatment involves:

  • Helping you understand how the facial nerve and muscles work

  • Education on stages of nerve injuries and expectations for healing with each stage

  • Advice about eye care, how to make speaking easier, how to make drinking and eating easier, and how to manage symptoms of dry mouth or dry eye

  • Soft tissue work to do at home daily including massage and stretching to help normalize the tone on both sides of the face

  • Muscle work to help relearn precise coordination for movement and facial expressions

  • Retraining imbalanced or unwanted face movements

  • Treatments may involve referral to other members of the multidisciplinary team at UHN including ENT, plastics, neurology or psychiatry

Fees
In-clinic and virtual appointments 

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$180

New patient assessment
90 minutes

Comprehensive assessment, clinical diagnosis, communication with your physician, and starting your treatment program. Call 416 697-1002 or book online.

$130

Follow up appointment
60 minutes

Individualized treatment, including re-evaluation and progressing your program. Call 416 697-1002 or book online.

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Cancellations
Please let us know as soon as possible if you are not able to make your appointment. We require 24 hours notice for cancellations. Late cancellations and no shows are billed at the full rate.

Payment
We accept Visa, Mastercard, and debit.