Beyond motor recovery: emerging perspectives in the management of peripheral facial palsy-a narrative review.

BACKGROUND: Peripheral facial palsy (PFP) is a common cranial nerve disorder that may result in persistent impairments extending beyond facial muscle weakness, including facial asymmetry, synkinesis, altered emotional expression, and reduced quality of life. Traditional rehabilitation approaches have predominantly focused on motor recovery and facial muscle function. However, emerging evidence suggests that somatosensory processing, body awareness, body image, and sensorimotor integration may play a more substantial role in recovery and long-term outcomes than previously recognized.

AIMS AND METHODS: This narrative review aims to synthesize current evidence regarding multimodal rehabilitation strategies for PFP, with particular emphasis on craniofacial somatosensory disturbances and their clinical implications. The literature was reviewed across three domains: (A) peripheral facial palsy and related diagnoses, (B) assessment of facial somatosensory distortion and body representation, and (C) interventions targeting somatosensory dysfunction. In addition to established clinical examinations and patient-reported outcome measures, emerging assessment strategies addressing body representation, self-perception, and sensory discrimination are discussed.

RESULTS: The review highlights growing evidence supporting the integration of somatosensory and neurocognitive approaches into clinical management. Altered facial perception and disrupted sensorimotor integration may contribute to persistent dysfunction and reduced participation. To address these mechanisms, a structured neurocognitive rehabilitation framework, the 8-E model, is presented. Furthermore, targeted somatosensory interventions, including two-point discrimination training, auditory acuity training, and trigeminal blink reflex training, and pre- and post-lesion experience using autobiographical memory are proposed to enhance sensory discrimination, cortical representation, and sensorimotor integration.

CONCLUSION: Current findings suggest that a broader biopsychosocial and neurocognitive perspective may complement conventional motor rehabilitation in PFP. Future research should investigate the clinical effectiveness of somatosensory-based interventions and further clarify their role in optimizing functional recovery, participation, and quality of life.