Physiotherapist brings 'dead' facial nerves to life

A physiotherapist based at Southampton’s teaching hospitals has discovered movement in the faces of patients with ‘dead’ nerves – by stretching the inside of their mouths with her finger.

The finding, made by specialist neurological physiotherapist Lorraine Clapham at Southampton General Hospital, gives hope to patients who suffer from facial palsy, where damage to nerves from injury, surgery or unexplained syndromes causes muscles to weaken and droop.

The most common cause of facial paralysis, Bell’s Palsy, accounts for approximately 23 cases per 100,000 people and, although most will make a good recovery, some may be left with a weakness.

By stretching the inside of the cheeks of several patients with complete facial nerve palsy with a finger while performing routine checks for ulcerations or trauma, Ms Clapham caused the paralysed facial muscles to move – something not seen before.

The breakthrough, reported in The Journal of Laryngology & Otology and named Clapham’s sign, is currently under further investigation, but it is believed it may help maintain muscle metabolism and prevent wastage to kick-start movement in patients struck by a syndrome or help patients who have undergone surgery make a quicker recovery.

Ms Clapham, who established pioneering clinic The Face Place at Southampton General Hospital in 2000 for patients who suffer from facial paralysis, said: “The presence of this sign may be an important indicator regarding the recovery of the facial nerve and movements of the face."

She added: “It may also help surgeons decide if and when surgery should be offered to try and restore facial movements.”

The patients’ responses took a minimum of six to seven weeks to appear following injury or surgery and continued for up to seven months following the nerve damage.

Ms Clapham, who has worked in the NHS for more than 30 years and was named the Department of Health’s outstanding achiever of the year in 2003 and physiotherapist of the year in 2007, was made a fellow of the Chartered Society of Physiotherapy in November.

Posted on Thursday 23 June 2011