title: Combined protocol for treatment of secondary effects from facial nerve palsy.
abstract: CONCLUSIONS
  Rehabilitation was significantly efficient in both groups of patients with synkinesis, especially in those in whom treatment with botulinum toxin type A (BTX-A) preceded physical rehabilitation.
  
  
  OBJECTIVE
  To determine the influence of preventive treatment with BTX-A on synkinesis when physical rehabilitation is planned.
  
  
  METHODS
  Twenty patients, who recovered from facial palsy with final House-Brackmann (HB) grade II and III, were randomized to assess the efficacy of preventive BTX-A treatment on final synkinesis score after physical rehabilitation. Synkinesis was graded according to the four-point scale derived from the SunnyBrook Facial Grading System (FGS). Physical rehabilitation was carried out using NeuroMuscular Retraining Therapy (NMRT). In the randomized groups, NMRT was administered with (group a) or without pre-BTX-A treatment (group b).
  
  
  RESULTS
  Patients who were preliminarily treated with BTX-A in the affected area showed a 2.1 improvement of score on the SunnyBrook scale (p < 0.001), with significantly better results in comparison to the non-BTX-A group.
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Monini
authors.forename: Andrea
authors.initials: A
authors.lastname: De Carlo
authors.forename: Michela
authors.initials: M
authors.lastname: Biagini
authors.forename: Antonella
authors.initials: A
authors.lastname: Buffoni
authors.forename: Luigi
authors.initials: L
authors.lastname: Volpini
authors.forename: Antonio Ivan
authors.initials: AI
authors.lastname: Lazzarino
authors.forename: Maurizio
authors.initials: M
authors.lastname: Barbara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000627:therapeutic use; D005154:Facial Nerve / Q000502:physiology*; D005158:Facial Paralysis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use; D026741:Physical Therapy Modalities; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A