Advances in the Diagnosis and Treatment of Peripheral Facial Palsy: From Pathophysiology to Rehabilitation/Recovery

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Background

Peripheral facial palsy (PFP) is a neurological disorder characterized by unilateral facial weakness due to dysfunction of the facial nerve. While Bell’s palsy is the most common idiopathic form, PFP can also result by a broad spectrum of disorders including infections, trauma, tumors, iatrogenic lesions or systemic diseases. Patients often experience physical complaints like corneal irritation, difficulties with drinking and eating, as well as speech disturbances. Additionally, facial asymmetry and impaired expressiveness can lead to emotional distress and social withdrawal.

Although many patients recover well, a significant subset suffers from persistent dysfunction, including synkinesis, muscle weakness, and involuntary movements. The extent of recovery depends on the severity of nerve damage and the effectiveness of early intervention. Despite advances in pathophysiology and electrophysiology, predicting recovery remains challenging. Current diagnostic tools, such as clinical assessments, electromyography, and imaging, help guide management but lack precision in forecasting long-term outcomes.

Treatment options range from corticosteroids and antivirals for Bell’s palsy to surgical decompression and rehabilitation for other forms. Physiotherapy techniques, including neuromuscular re-education and electrical stimulation, show promise, but their efficacy varies. Emerging research on neuroplasticity and nerve regeneration offers new insights, yet significant gaps remain in optimizing personalized treatment and predicting individual recovery trajectories.

Despite advancements in the diagnosis and treatment of peripheral facial palsy (PFP), a substantial number of patients experience persistent facial dysfunction, including synkinesis, weakness, and asymmetry. Current treatment approaches often yield inconsistent outcomes, highlighting the need for a deeper understanding of the factors influencing recovery. Early and precise diagnosis remains challenging, particularly in distinguishing reversible cases from those at risk of long-term impairment. Additionally, rehabilitation strategies vary widely, and there is limited consensus on the most effective interventions for optimizing neural regeneration and functional recovery.



To address these challenges, this Research Topic aims to integrate findings from basic science, clinical research, and technological innovations. Advancements in neuroimaging, electrophysiology, and biomarker discovery may enhance diagnostic accuracy, while novel rehabilitation techniques and emerging digital health applications could improve therapeutic outcomes. By fostering interdisciplinary collaboration, this collection seeks to identify evidence-based strategies for personalized treatment, ultimately improving the prognosis and quality of life for patients with PFP.

This Research Topic aims to provide a comprehensive overview of recent advances in the diagnosis, treatment, and recovery of peripheral facial palsy (PFP). We welcome contributions that explore novel insights into its underlying mechanisms, innovative diagnostic tools, and cutting-edge therapeutic approaches. The scope includes, but is not limited to, the following themes:
• Pathophysiology and Etiology: New insights into the mechanisms underlying PFP.
• Diagnostic Innovations: Advances in imaging, electrophysiology, and biomarkers for diagnosis and prognosis.
• Rehabilitation and Physiotherapy: Novel techniques such as facial exercises, neuromuscular re-education, and electrical stimulation.
• Surgical Interventions: Indications, techniques, and outcomes of surgical approaches.
• Neuroplasticity and Functional Recovery: Mechanisms of spontaneous recovery and strategies to enhance neural regeneration.
• Emerging Technologies: The role of AI, machine learning, and digital health in assessment and treatment.

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This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

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  • Hypothesis and Theory
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Keywords: facial palsy, reconstruction, rehabilitation, diagnostic, pathophysiology, electrophysiology, synkinesis, neuroplasticity

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