What is the reason for the lack of expression on the face of Parkinson’s patients?

  Patients with Parkinson’s disease often have a dull, expressionless face with fewer eye rolls and fewer transients, as if they were wearing a mask, hence the name “mask face”. In fact, this expression is not a response to abnormal emotions, but is due to the reduced facial muscle expression activity.  People express various emotions such as happiness, anger, sadness and joy by controlling the movement of facial muscles. The facial expression muscles mainly include cranial parietal muscles, frontal muscles, orbicularis oculi, laughing muscles, zygomaticus major, and orbicularis oris, etc. They start from different parts of the skull and end at the skin, and are distributed around the cleft of the mouth, cleft of the eyes and nostrils, and contract under the innervation to pull the skin to show various expressions. Motor retardation is one of the main symptoms of Parkinson’s disease. When the face is involved, there is a reduction in the casual movement of expressions, muscle stiffness and a significant reduction in the amplitude of movement, and a slow response when laughing or making other expressions, often accompanied by excessive prolongation of expressions.  In some patients, the facial expression impairment may appear only on the same side of the face as the affected limb, or may be more severe on the affected side and less severe on the opposite side. When oral drugs and other medications are used to control the motor symptoms of Parkinson’s disease, patients’ facial expressions often improve subsequently. Generally, after 3-5 years of medication, Parkinson’s disease symptoms can no longer be effectively controlled and anomalies appear, early evaluation of deep brain electrical stimulation surgery (brain pacemaker) is recommended to improve the quality of life.  The special face of Parkinson’s disease patients is the “mask face”, which is due to the stiffness of facial muscles, resulting in dull facial expressions, so it is necessary to do some facial movement exercises.  Frowning action: frown as much as possible, and then forcefully spread the eyebrows, repeated several times.  Open and close the eyes with force, cheek puffing exercise: first puff up the cheeks with force, and then try to inhale both cheeks.  Open teeth and whistle action: try to show the teeth, followed by whistling action.  In front of the mirror, let the face show a smile, smile, smile with teeth, pout, whistle, puff cheeks, rub the face, etc.