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Does Cerebral Palsy Affect the Face? Effects and Management

speech therapist helping girl with cerebral palsy manage motor impairments of the face

When cerebral palsy affects the muscles in the face, it can impact an individual’s ability to communicate, control their breathing, and eat. As a result, it can be challenging for the individual to convey their needs and socialize. Fortunately, there are several ways to improve or compensate for motor impairments in the facial muscles to enhance one’s quality of life.

To help you understand what to expect when cerebral palsy affects the muscles in the face, this article will discuss:

Is it Common for Cerebral Palsy to Affect the Muscles in the Face?

Cerebral palsy is the result of damage to the areas of the brain that control motor functions. Depending on the location and severity of the damage, voluntary control over the muscles in any area of the body can be affected, including the muscles in the face.

Motor impairments in the facial muscles can occur in all types of cerebral palsy (spastic, dyskinetic, and ataxic). However, they are more common in individuals with dyskinetic cerebral palsy than spastic or ataxic forms.

Additionally, the prevalence of facial motor impairments in individuals with cerebral palsy increases with decreasing gross motor function. This means that the more severe the individual’s cerebral palsy is, the more likely it is for the facial muscles to be affected.

Motor impairments in the face are common amongst individuals with cerebral palsy. In fact, research suggests that:

  • 25% of individuals with CP are non-verbal
  • 1 in 15 individuals with CP require non-oral feeding
  • 50% of individuals with CP experience motor-based speech impairments (dysarthria)

In the following section, we’ll discuss the effects of facial motor impairments in individuals with cerebral palsy.

Effects of Facial Motor Impairments in Individuals with Cerebral Palsy

baby with cerebral palsy struggling to eat because of facial motor impairments

Cerebral palsy can affect various muscles in the face, including the ones that make up the tongue, throat, and mouth. This can affect a wide range of functions, making it challenging to communicate, eat, and breathe.

Secondary effects [1],[2] of facial motor impairments include:

  • Difficulties with chewing and swallowing
  • Drooling
  • Choking
  • Difficulties controlling breath
  • Impaired speech or inability to speak
  • Difficulties with facial expression
  • Prolonged feeding times
  • Snoring
  • Malnutrition and consequently impaired growth
  • Quiet or soft speech

Many of these effects can cause individuals with cerebral palsy to experience social isolation and struggle with their emotional wellbeing. It’s important to understand that just because an individual may struggle to communicate does not mean that they are any less intelligent. Many individuals with cerebral palsy can understand what you are saying and know what they want to say back. However, their facial motor impairments may prevent them from effectively communicating their thoughts verbally.

Luckily, many individuals with cerebral palsy may be able to improve their facial motor control by engaging their brain’s natural ability to adapt, neuroplasticity. Up next, we’ll discuss what neuroplasticity is and the most effective way to promote it.

Is it Possible to Treat Motor Impairments in the Face?

Lack of facial control in individuals with cerebral palsy is caused by damage to the brain, not the muscles. Therefore, to improve these functions, you must target adaptive changes in the brain.

Neuroplasticity is the brain’s ability to make neuroadaptive changes based on the behaviors we repetitively practice. The key to strengthening control over the facial muscles is to consistently engage them. Task-specific and repetitive practice helps stimulate the brain and reinforces demand for those functions. As a result, facial functions affected by brain damage can be rewired to unaffected regions of the brain and strengthened.  

Learn more about neuroplasticity in individuals with cerebral palsy »

Up next, we’ll discuss management interventions that can help individuals with cerebral palsy promote neuroplasticity or compensate for lack of facial motor control.

How to Manage Cerebral Palsy that Affects the Facial Muscles

Every case of cerebral palsy is unique and individuals may experience various degrees of facial motor impairments. As a result, management techniques should be personalized for each individual’s specific functional outcomes.

Below, we’ll discuss interventions that can help individuals with cerebral palsy manage facial motor impairments.

Participate in Speech Therapy

Participating in speech therapy can help individuals with facial motor impairments strengthen their communication and feeding skills.

A speech-language pathologist can assess the severity of one’s facial motor impairments and create a custom rehabilitation plan consisting of activities and exercises to help strengthen the facial muscles, improve communication skills, and increase social participation.  

They may also use specialized electrical stimulation devices for the face, such as VitalStim, to promote increased communication between the orofacial muscles and the brain.  

Implement New Feeding Techniques

Another helpful way to manage facial impairments is to implement new feeding techniques. This may include:

  • Blending food to change the consistency, reduce chewing, limit the likelihood of choking, and make food easier to swallow
  • Thickening drinks to reduce the likelihood of aspiration (breathing liquid into the lungs)
  • Scheduling longer meal times
  • Using a surgically-inserted feeding tube
  • Taking supplements to help fill in gaps in nutrition

These practices can help ensure that children with cerebral palsy have adequate nutritional intake to support optimal growth and development.

Use Augmentative and Alternative Communication

Individuals with severe facial muscle impairments may be unable to generate verbal speech. To compensate and allow the individual to be an effective communicator, a speech-language pathologist may recommend learning how to use augmentative and alternative communication (AAC).

AAC consists of using various techniques and devices such as communication boards, gestures, and voice generators to effectively communicate with others.

Use Speech Therapy Apps

speech therapy app for facial motor impairments

One way to practice more repetitions of facial muscle exercises and promote neuroplasticity is to download speech therapy apps onto your phone or tablet. For example, the CT speech and cognitive therapy app includes over 100,000 speech therapy exercises designed by speech-language pathologists. Speech therapy apps provide 24/7 access to effective speech therapy activities so you can practice wherever and whenever is convenient for you.

Practice Correct Posture

Compromised posture can limit lung capacity and make it challenging for individuals to breathe. Along with difficulties controlling the muscles that make up the mouth, individuals with cerebral palsy may be susceptible to respiratory complications.

By promoting correct posture (through the use of orthotic devices and practicing core-strengthening exercises), individuals can improve breathing efficiency. This may lead to less fatigue and improved functioning of the body due to increased oxygen supply.

How Cerebral Palsy Affects the Face: Key Points

Cerebral palsy can affect motor functions throughout the entire body, including the face. As a result, individuals may struggle with communication, feeding, and breathing. Fortunately, there are several ways to ensure that individuals with facial motor impairments receive adequate nutrition and learn to be effective communicators.

We hope this article helped you understand how cerebral palsy can affect the muscles in the face and how to effectively manage associated complications.

photo credits: iStock/KatarzynaBialasiewicz/OtmarW

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You’re on a Roll: Discover a home exercise program for CP that’s actually fun to do!

adult with cerebral palsy smiling while using FitMi home therapy

Finally! There’s a recovery device for CP that’s actually fun to use. See how Flint Rehab’s tools are helping with CP recovery:

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Music is a motivator for him. He has been using it on his arm and we will try the leg exercises soon.”

FitMi works by motivating high repetition of therapeutic exercises while playing an engaging game. This gamification has been particularly great for motivating individuals with cerebral palsy to recover.

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