OBJECTIVE: To determine the effect of facial neuromuscular re-education over conventional therapeutic measures in improving facial symmetry in patients with Bell's palsy. DESIGN: Randomized controlled trial. SETTING: Neurorehabilitation unit. SUBJECTS: Fifty-nine patients diagnosed with Bell's palsy were included in the study after they met the inclusion criteria. Patients were randomly divided into two groups: control (n = 30) and experimental (n = 29). INTERVENTIONS: Control group patients received conventional therapeutic measures while the facial neuromuscular re-education group patients received techniques that were tailored to each patient in three sessions per day for six days per week for a period of two weeks. MAIN MEASURES: All the patients were evaluated using a Facial Grading Scale before treatment and after three months. RESULTS: The Facial Grading Scale scores showed significant improvement in both control (mean 32 (range 9.7 to 54) to 54.5 (42.2 to 71.7)) and the experimental (33 (18 to 43.5) to 66 (54 to 76.7)) group. Facial Grading Scale change scores showed that experimental group (27.5 (20 to 43.77)) improved significantly more than the control group (16.5 (12.2 to 24.7)). Analysis of Facial Grading Scale subcomponents did not show statistical significance, except in the movement score (12 (8 to 16) to 24 (12 to 18)). CONCLUSION: Individualized facial neuromuscular re-education is more effective in improving facial symmetry in patients with Bell's palsy than conventional therapeutic measures.

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