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Of main consideration regarding the optimal management for a person with facial paralysis are the cause and duration of the paralysis. In cases of congenital (present since birth) facial paralysis, the facial nerve and facial muscles may not have developed appropriately or may be absent.Attempting to provide a new nerve source to these muscles, then, is not logical or possible, but other types of reconstruction are possible.nce a muscle has lost its nerve source for any reason, there is a window of opportunity to provide a nerve to those original muscles. After that window has passed, usually about 12-24 months, the original muscles can no longer accept a nerve. In those cases, a nerve supply as well as new muscle must be provided.
1 Because alpha motor neurons are the only way to stimulate extrafusal muscle fibers, the loss of these neurons causes a decrease in muscle tone. 2  Hyporeflexia. 3  The myotatic (stretch) reflex is weak or absent with lower motor neuron disorders, because the alpha motor neurons that cause muscle contraction are damaged. Fibrillation. 2  With further degeneration of the alpha motor neuron, only remnants of the axons near the muscle fibers remain. 3  These individual axon fibers can also generate spontaneous action potentials; however, these action potentials will only cause individual muscle fibers to contract.