Ramsay Hunt patients often wonder if there is some therapy that will help them get back their normal facial movements. Unfortunately, only time and the body's natural healing process will heal the injured nerves that activate the facial muscles. These are our recommendations for facial muscle treatment during the three stages of Ramsay Hunt Syndrome:

Immediately After Onset

As mentioned above, a key element to the recovery process is time. In the first few days or even weeks after facial paralysis the affected side will be inflamed either visibly or internally. Either way nerves will need time to repair before you consider performing any kind of muscular stimulation.

The only kind of therapy you should try immediately after the onset of Ramsay Hunt Syndrome is warmth and very gentle circulatory massage.

During the Natural Healing Period

After the inflamation has subsided, portions of the myelin coating on your affected cranial nerves may be damaged and need time to regenerate. This is not a process that can be rushed. It will take months, even up to two years or more, for these nerves to heal.

During this time of regeneration, we do not advise performing any facial exercises or stimulation of the facial muscles, since forcing movement of the muscles is believed by many neurologists to encourage synkinesis.

There is no need to worry about atrophy of the facial muscles during this time, thus no need to exercise them. The facial muscles are designed to move only skin. Thus they have a different structure than that of the muscles that are designed to move heavy bones.

Longtimers

After the natural healing process has completed, which usually takes around two years, you may wish to undertake some kind of facial therapy.

Facial exercises should be performed only after consulting your doctor and/or under the supervision of a professional therapist. For those with facial paralysis resulting from Ramsay Hunt Syndrome, we recommend not forcing any movement of the facial muscles for two years post onset.

To begin with, you should always perform the exercises in front of a mirror so you can react off the feedback and control the movements to aid a balanced recovery. Any facial movement should always be performed gently and never forced or else you risk stimulating the wrong muscles or overstraining the right ones.

Perform each exercise slowly 10 times and repeat a two or three times a day:

• Raise your eyebrows and form horizontal wrinkles on your forehead (Surprise)
• Draw your eyebrows together and downwards forming vertical wrinkles between the eyebrows (Frowning)
• Lift the outside borders of your nostrils forming diagonal wrinkles along the bridge of your nose (Distaste)
• Draw your lips together and make a kissing motion (Pucker)
• Protrude your upper lip
• Smile without showing your teeth
• Smile and show your teeth
• Pull your lips tight and wide (Grimace)
• Purse your lips as if blowing through a straw
• Attempt to whistle
• Protrude your lower lip like a spoilt child
• Puff out your cheeks and hold the air. Try to transfer the air from one side of mouth the other
• Close eyes together tightly
• Open your eyes wide
• Wink each eye alternately

Don't rush or force any movements or exercises and don't be under the assumption that constant exercising will speed recovery. In fact a number of sufferers have never performed any kind of extra facial stimulation and have made a full recovery.

For people who have long term facial paralysis it may be necessary to seek professional attention and perform other methods of recuperation under specialist supervision.