Facial impairment is present in 75% of people with facioscapulohumeral muscular dystrophy (FSHD), and represents a significant psychosocial burden for a third.
Given this distress, a team of Dutch clinicians looked at the treatments and psychosocial interventions used in FSHD and other pathologies where facial expression is impaired, such as facial paralysis, Moebius syndrome, myotonic dystrophy type 1 or Parkinson’s disease.
In the literature, she identified five categories of techniques for modifying facial mimicry and quality of life, applicable in FSHD:
- learning compensatory (non-verbal) communication strategies,
- speech therapy,
- facial rehabilitation,
- participation in patient meetings,
- surgical restoration of the smile.
Of the 40 publications, only three case reports concerned FSHD. Improvements, notably in lower lip eversion, followed dermal filling on either side of the chin, facial acupuncture or lower lip lift surgery.
The authors conclude that it is important to evaluate these different strategies in FSHD on criteria that cover aesthetic, functional, communication and quality-of-life aspects related to facial involvement.
