What is Facial Hyperkinesis?
Facial hyperkinesis is a condition characterised by excessive or overactive facial muscle activity following an injury to the facial nerve. Rather than weakness, the affected muscles become overly active, causing unwanted facial tightness, exaggerated movements or facial asymmetry.
Hyperkinesis often develops during recovery from conditions such as:
- Bell's palsy
- Ramsay Hunt syndrome
- Facial nerve injury
- Parotidectomy
- Acoustic neuroma (vestibular schwannoma) surgery
- Other facial nerve disorders
It commonly occurs alongside synkinesis, where unwanted muscles contract during voluntary facial movements. For example, smiling may cause excessive eye closure, or blinking may result in unwanted movement around the mouth or neck.
Symptoms of facial hyperkinesis can affect facial appearance, speech, eating, drinking and confidence, but specialist rehabilitation can help improve muscle control and facial symmetry.
How Can Physiotherapy Help?
Facial hyperkinesis is treated by reducing excessive muscle activity and improving selective control of facial movements. Rehabilitation focuses on retraining the nervous system to produce smoother, more coordinated facial expressions.
Treatment may include:
- Comprehensive facial movement assessment
- Neuromuscular retraining
- Facial muscle relaxation techniques
- Selective muscle activation exercises
- Mirror feedback therapy
- Biofeedback training where appropriate
- Stretching for facial tightness
- Soft tissue massage
- Synkinesis management
- Functional retraining for smiling, blinking and speech
- Personalised home exercise programme
Where appropriate, physiotherapy may also be used alongside treatments such as botulinum toxin (Botox®) injections to optimise outcomes.
Our aim is to reduce excessive muscle activity while restoring natural, relaxed facial movement.
Why Choose Greenacre Physio?
Facial rehabilitation is one of Greenacre Physio's specialist neurological services. Our clinicians have extensive experience managing facial hyperkinesis through specialist NHS neurological services and dedicated facial rehabilitation clinics.
We understand that excessive facial muscle activity can be just as distressing as facial weakness, affecting confidence, communication and quality of life. Using evidence-based rehabilitation techniques, we provide personalised treatment programmes that focus on improving facial control and restoring more natural facial expressions.
Appointments are available at our Essex and Cambridge clinics, with virtual consultations also available where appropriate.
What to Expect
Your first appointment will include a detailed discussion about your facial nerve injury, recovery and current symptoms. We will assess your resting facial posture, facial symmetry, muscle overactivity, voluntary facial movements and any associated synkinesis.
Following your assessment, we will explain your movement pattern and develop a personalised rehabilitation programme. Your treatment will focus on reducing muscle overactivity while improving selective facial movement and overall facial function.
Frequently Asked Questions
What causes facial hyperkinesis?
Facial hyperkinesis usually develops as the facial nerve heals following an injury. During recovery, changes in nerve signalling can lead to excessive muscle activity, often occurring alongside synkinesis.
Can physiotherapy improve facial hyperkinesis?
Yes. Specialist facial physiotherapy can help reduce muscle overactivity, improve facial symmetry and teach better control of facial movements. Treatment focuses on improving movement quality rather than strengthening the muscles.
Is facial hyperkinesis permanent?
Symptoms vary between individuals. Many people experience significant improvement with specialist rehabilitation, particularly when treatment is started early. Others may require ongoing management to maintain facial function.
Can physiotherapy be combined with Botox?
Yes. Physiotherapy is often used alongside botulinum toxin injections prescribed by a specialist. Botox can reduce excessive muscle activity, while physiotherapy helps retrain normal movement patterns and maximise the benefits of treatment.
Do I need a referral?
No. You can self-refer directly to Greenacre Physio. We also accept referrals from GPs, neurologists, ENT consultants, plastic surgeons, maxillofacial surgeons and other healthcare professionals.
Book an Appointment
If you're experiencing facial tightness, exaggerated facial movements or have been diagnosed with facial hyperkinesis, we're here to help. Book an appointment at one of our Essex or Cambridge clinics or arrange a virtual consultation with one of our experienced facial rehabilitation physiotherapists.
We'll provide a personalised rehabilitation programme to help improve facial control, reduce unwanted muscle activity and restore confidence in your facial expressions.
Common Symptoms We Treat
- Excessive facial muscle activity
- Facial tightness
- Facial stiffness
- Exaggerated smiling
- Eye narrowing during facial movement
- Facial asymmetry
- Synkinesis
- Neck muscle overactivity
- Difficulty producing relaxed facial expressions
- Facial discomfort
- Reduced confidence with facial appearance
Why Choose Greenacre Physio for Facial Hyperkinesis?
Managing facial hyperkinesis requires specialist knowledge of facial nerve recovery and neuromuscular rehabilitation. At Greenacre Physio, we combine extensive experience from specialist NHS neurological services and dedicated facial rehabilitation clinics to deliver evidence-based treatment tailored to your individual needs.
Whether your symptoms developed following Bell's palsy, Ramsay Hunt syndrome, parotid surgery, acoustic neuroma surgery or another facial nerve injury, we'll work with you to reduce excessive muscle activity, improve facial symmetry and restore more natural facial movement. Our personalised rehabilitation programmes are designed to help you regain confidence, improve function and achieve the best possible long-term outcome.