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Patient Name DOB UW Health University of Wisconsin Hospitals and Clinics Authority MR SYNKINESIS ASSESSMENT QUESTIONNAIRE WORKSHEET Date Please answer the following questions regarding facial function with regard to the affected side of the face with facial paralysis on a scale from 1 to 5 according to the following rankings 1 seldom or not at all 2 occasionally or very mildly 3 sometimes or mildly 4 most of the time or moderately 5 all the time or severely Question Score 1-5 When I smile my...

How to fill out synkinesis assessment questionnaire

How to fill out synkinesis assessment questionnaire

1. To fill out the synkinesis assessment questionnaire, follow these steps:
2. Start by carefully reading through each question.
3. For each question, select the response option that best applies to your situation.
4. Make sure to answer all the questions honestly and accurately.
5. If a question is unclear, refer to any provided instructions or consult a healthcare professional for clarification.
6. Once you have completed all the questions, review your responses to ensure they are complete.
7. Submit the filled-out questionnaire as per the instructions provided.

Who needs synkinesis assessment questionnaire?

1. The synkinesis assessment questionnaire is needed by individuals who are experiencing synkinesis.
2. Synkinesis refers to the abnormal involuntary movement of one muscle or group of muscles that occurs simultaneously with intentional movement of another muscle or group of muscles. It commonly occurs after facial nerve injury or other types of nerve damage.
3. This questionnaire helps in evaluating the severity and impact of synkinesis on daily activities, and is typically used by healthcare professionals, such as doctors or physical therapists, to assess the condition and develop appropriate treatment plans.

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What is synkinesis assessment questionnaire?

Synkinesis assessment questionnaire is a tool used to assess and document the presence and severity of synkinesis in individuals.

Who is required to file synkinesis assessment questionnaire?

Healthcare professionals who are treating patients with synkinesis are required to file the assessment questionnaire.

How to fill out synkinesis assessment questionnaire?

To fill out the questionnaire, healthcare professionals must evaluate the patient's facial movements and document any signs of synkinesis.

What is the purpose of synkinesis assessment questionnaire?

The purpose of the questionnaire is to track the progression of synkinesis, monitor the effectiveness of treatment, and provide a standardized tool for assessing patients.

What information must be reported on synkinesis assessment questionnaire?

The questionnaire must include details on the patient's facial movements, any observed synkinesis, the severity of the condition, and any treatments being administered.