What is a Facial Palsy?
Facial palsy refers to weakness or paralysis of the muscles of the face. This typically occurs on one side of the face and results from damage or dysfunction of the Facial Nerve (Cranial Nerve 7). Damage to the Facial Nerve can affect everyday functions such as blinking, closing the eye, smiling, speaking, and eating. Depending on where the nerve is damages, tear and saliva production can also be affected, and alterations in taste and increased sensitivity to sound may be present. While this is typically not a painful condition, there can be pain behind the ear. If the Facial Nerve is injured, you will notice drooping of the face on the same side with an inability to close the eye.
Types of Facial Palsy
The most common form of facial palsy is Bell’s palsy, which typically appears suddenly and is often temporary, but facial palsy can also arise from infections, trauma, tumors, neurological conditions or, can be present since birth. Symptoms vary in severity and will depend on where the damage occurred along the path of the nerve as well as the severity of damage to the nerve.
How are Facial Palsies Treated?
Treatment of Facial Palsies can be multi-disciplinary depending on the cause, clinical presentation and degree of recovery. Early assessment and appropriate treatment are important to improve recovery and prevent complications. Management may include medications, eye protection strategies, facial neuromuscular rehabilitation and, in some cases, surgical intervention. Many individuals experience partial or full recovery over time, especially with prompt care. Supportive therapies and rehabilitation can also help restore function and confidence, improving overall quality of life for those affected.
What is Facial Neuromuscular Rehabilitation?
Facial neuromuscular rehabilitation is a specialized, non-invasive therapy designed to retrain the facial muscles and improve coordination, symmetry, and control. It is particularly helpful for those with prolonged or incomplete healing. Through targeted exercises, manual techniques, and biofeedback, this approach helps patients relearn proper movement patterns while reducing unwanted muscle activity such as hyperkinesia (overactivation of the non-paralyzed side of the face) or synkinesis (involuntary movements on the paralyzed side of the face that occur at the same time as the voluntary movement). Tailored to each individual’s needs, facial neuromuscular rehabilitation plays a key role in optimizing recovery, enhancing facial expression, and supporting long-term functional and aesthetic outcomes.
Our Facial Therapist:
Denise Fogal-Smith, PT
Denise is a graduate of the University of Toronto where she obtained both a Bachelor of Science in Physical Therapy (1990) and a Master of Science in Physiology (1993). In her graduate training she studied balanced control in stroke survivors. Since 1993 she has been an active clinician practicing in the areas of orthopedic and neurological physiotherapy. In 1997 she co-founded Motion Plus Physiotherapy is currently a Partner and Clinical Director.
In her 35+ years of clinical practice, Denise has taken many orthopedic and neurological continuing education courses. More recently, Denise developed an interest in the treatment of facial palsies. She completed 2 recognized courses in facial rehabilitation in 2025: A Multidisciplinary Approach to the Management of Acute Facial Palsy through Facial Therapy Specialists International and a hands-on, 3 day workshop in Facial Neuromuscular Retraining with Beth Kroetsch, PT a facial neuromuscular therapist in Burlington, Ontario. Denise continues to participate in mentoring programs with Beth and other trained therapists in the GTHA. Both the workshop and mentoring have provided Denise with valuable opportunities to assess and treat patients with incomplete recovery and chronic facial paralysis.
For Denise’s complete profile please visit Our Team/Registered Physiotherapists.