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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.
Calcium is then pumped back into the sarcoplasmic reticulum breaking the link between actin and myosin. Actin and myosin return to their unbound state causing the muscle to relax. Alternatively relaxation (failure) will also occur when ATP is no longer available. In order for a skeletal muscle contraction to occur; 1. There must be a neural stimulus. 2. There must be calcium in the muscle cells. 3. ATP must be available for energy. So, a few things can stop a contraction; 1. Energy system fatigue: There is no more ATP left in the muscle cell so it canât keep contracting. 2. Nervous system fatigue: The nervous system is not able to create impulses sufficiently or quickly enough to maintain the stimulus and cause calcium to release.