To investigate the incidence of several different types of synkinesis following facial nerve palsy in patients presenting to an Oculoplastics clinic. Synkinesis describes an undesired facial movement accompanying a voluntary movement. It may affect all facial muscle groups following facial nerve palsy.

Patients were observed prospectively using a standardized synkinesis questionnaire. Each patient was instructed to perform intentional movements such as puckering lips, lifting eyebrow, snarl and eyelid closure. Synkinetic movements recorded included chin dents, lifting mouth, platysma contraction and eyelid closure, the latter being the most familiar to ophthalmologists.

The reported incidence of synkinesis post facial palsy varies greatly from 15 to 100% depending on the cohort of patients studied. We present data collected at Southampton Eye Unit to show the high frequency of post facial palsy synkinesis and the varying types of synkinesis encountered.

In post facial nerve palsy patients, the synkinetic movement ophthalmologists are most commonly aware of is eyelid closure. Other sites of synkinetic movements are often under diagnosed in the ophthalmology clinic. The presence of synkinesis may have a distressing effect on facial function, cosmesis and quality of life and early diagnosis combined with rehabilitation may be beneficial. It is therefore important for ophthalmologists to be aware of the frequency of all types of synkinetic movements following facial nerve palsy.