In Bell’s palsy, patients can typically recover facial nerve function on their own. However, in some cases, this can be a longer process. In those patients that take a longer time to recover, sometimes they phenomenon occurs called synkinesis. And what is synkinesis? This is a problem of reinnervation. In other words, there’s a miswiring of the various facial nerve branches during the recovery phase of Bell’s Palsy. In other words, when a nerve shuts down, it really has to start over again. The facial nerve has to regenerate from the point of the injury or the inflammation all the way down the channels into the facial muscles again. During this process, because of the thousands of interconnected networks of little nerves that constitute the facial nerve further downstream, you can get a miswiring or a redirection of that signal into another part of the face. For example, when patients try to smile, they can trigger the closure of the eye or a spasm of the eye and vice versa. There’s all sorts of combinations and patterns of synkinesis that can be very distressing to a patient. And the treatment for these can be quite challenging.