Expressionless Face

Posted: Sun Nov 11, 2007 1:53 pm Post subject: Expressionless Face

Early in the disease, family members may notice changes in a person with Parkinson’s disease facial expression. Doctors use the term masked face or hypomimia to describe the loss of spontaneous facial expression and the decreased frequency of blinking. Because of the loss of spontaneous facial expression, a person’s face may not reflect his or her emotions very well. The decreased frequency of blinking gives people the impression that the person with Parkinson’s disease is starting. A masked face can be mistaken for disinterest, apathy, dementia, depression or even hostility. But in reality, a masked face does not reflect any of these emotional states. Instead, if reflects the effect of Parkinson’s disease on the facial muscles. It is caused by the Parkinson’s rigidity and inadequate muscle activation of the muscles that control blinking and facial expression. Currently, there are no studies that demonstrate that facial exercises can improve facial expression. However one study by Spielman, Borod, and Ramig (2003) demonstrated that facial expression improved in persons with PD who received the Lee Silverman Voice Treatment (LSVT-LOUD). Similarly, medications taken to control PD symptoms do not improve facial expression. It is important for persons with PD to educate family members and friends about their masked expression and lack of facial animation. Saying something like, “I look this way because my Parkinson’s disease. I’m actually quite friendly, and I’m interested in what you’re saying!” Be sure to verbally express your mood and feelings to loved ones to let them know your true feelings. For example you could say, “I know I don’t look it but I’m really quite happy right now!” Dr. Celia Bassich