What is the focus of clinical history in the evaluation of congenital facial paralysis?

Updated: Jan 07, 2019
  • Author: Alan D Bruns, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Newborn children with facial paralysis may present with noted asymmetric facial movement, incomplete eye closing, and difficulties feeding. They may have other more significant symptoms from other congenital defects.

Determine the etiology of congenital facial nerve paralysis based on birth history, family history, physical examination, radiologic studies, and neurophysiologic tests.

Obtaining a thorough birth history in congenital facial paralysis is important. When the etiology is traumatic, the evidence often supports difficult labor caused by cephalopelvic disproportion. Risks for difficult labor include primiparity and birth weight more than 3500 g. The use of middle forceps delivery (as opposed to low forceps) also increases the risk of injury to the facial nerve, as does prolonged second-stage labor. [3]

A family history positive for facial paralysis or other congenital anomalies increases the suspicion for a developmental cause of the facial paralysis.

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