In your face

Breaking news on the facial front. Shade hasn’t been able to move the right side of his face since the stroke, and it’s likely that if we proceed with just facial exercises, he won’t progress much more. Basically the line is cut. However, during a visit to see Biofeedback Specialist Dr. Santini at Florida Hospital Pediatric Rehab facility, Aitza learned of another option. She mentioned a nerve graft technique that could restore his facial abilities.

What his face needs is a jump start. Essentially Shade’s facial nerves are not getting signal from the brain, much like a car with a dead battery. If you ran cables from another battery to that car, you could start it. In the same way, if you run a new firing nerve to the facial nerves, they should start up, too.

Currently two techniques are used. One grafts in the Gracilis nerve from the inner thigh. According to an article on Medscape.com: “The revascularized gracilis muscle is one of the few muscles that has been used to attempt to achieve the most elusive of facial palsy rehabilitative goals: restoration of spontaneous emotional expression.” In other words, he may be able to smile spontaneously, say at a funny joke or his dad walking around in his underwear on a Saturday morning. Worst case scenario is he would gain mobility in the face, be able to close his eye, and smile voluntarily, such as when he’s taking a picture and thinking about smiling, but not spontaneously. On this surgery, or surgeries as it involves two locations, the post op is not painful in the facial area, though the leg may be a bit sore. However, the nerve is considered expendable, so there should be few complications.

The other technique, a hypoglossal facial nerve transfer, would utilize a nerve in the tongue. The advantage here is that the nerve is already in the face. Really this method is tricking the face by using the tongue as a triggering method. For example, to smile, the patient has to contract the tongue. It takes practice but can look quite natural. There’s some small risk of increased tongue weakness, but the surgery is easier to do and has less side effects.

We still need to consult some surgeons about these methods and the benefits, risks and long term outcomes. We’ve got the numbers of a couple of surgeons in town that have performed these surgeries, but we also have contact info for some specialists that have mastered these techniques. One’s in Boston; the other is in Beverly Hills. Hopefully they’ll be covered under our insurance. The question is, which is worse: hanging out with Celtics fans or Laker fans? We’ll keep you updated on the info we get.

Don’t forget Shade’s Super Stride 5K coming up on September 15. I’m hoping to see a few capes, masks and unitards.

 

1 Comment (+add yours?)

  1. Aura
    Aug 28, 2012 @ 00:04:42

    Actor and good friend Robert Alexander Perez had a stroke a few years ago. I understand while in Orlando he had surgery to “trigger” a nerve that could allow him to smile, blink, and all that good stuff. He moved to Argentina, I am sending him your link so you guys can make contact. I am sure he will share some valuable info. Hugs!

    Reply

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