Facial Nerve Palsy in Children: Diagnostic Evaluation Tool

Is the onset acute?

How to ask:
• 'When did you first notice the facial deviation?'
• 'Did it come on suddenly or gradually?'
• 'Was the child completely normal before this?'
Acute (<24 hours):
• Bell's palsy
• Stroke
• Facial trauma
Subacute (days to weeks):
• Ramsay Hunt syndrome
• Facial cellulitis
• Parotitis
Gradual (weeks to months):
• Neoplasms
• Progressive neurological disorders
Clinical pearls:
• Document exact timing of onset
• Consider photos from before onset
• Note any preceding illness
Evaluation tips:
• Create symptom timeline
• Document progression pattern
• Consider immediate neuroimaging for acute onset

Differential Diagnosis:

Recommended Evaluations:

⚠️ RED FLAGS DETECTED ⚠️

Severity Assessment:

Related Conditions: Click to Read the Topics

Bell's Palsy Congenital Facial Palsy Facial Trauma Stroke in Children Ramsay Hunt Syndrome Hemifacial Microsomia Facial Nerve Anatomy House-Brackmann Scale

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House-Brackmann Facial Nerve Grading Scale

Grade	Description	Characteristics
I	Normal	Normal facial function in all areas
II	Mild Dysfunction	Slight weakness noticeable on close inspection. Complete eye closure with minimal effort. Slight asymmetry of smile with maximal effort.
III	Moderate Dysfunction	Obvious but not disfiguring difference between sides. Complete eye closure with effort. Mouth slightly asymmetric with maximal effort.
IV	Moderately Severe Dysfunction	Obvious weakness and/or disfiguring asymmetry. Incomplete eye closure. Asymmetry of mouth with maximal effort.
V	Severe Dysfunction	Only barely perceptible motion. Incomplete eye closure. Slight movement corner mouth.
VI	Total Paralysis	No movement, loss of tone, no function.

Select Grade: Grade I - Normal Grade II - Mild Dysfunction Grade III - Moderate Dysfunction Grade IV - Moderately Severe Grade V - Severe Dysfunction Grade VI - Total Paralysis

Facial Nerve Function Tests

Document specific facial function:

Eyebrow Raise: Normal Partial Weakness Absent Function

Eye Closure: Complete Incomplete No Function

Nasolabial Fold: Normal Flattened Absent

Smile/Show Teeth: Symmetric Asymmetric No Movement

Lower Lip Movement: Normal Partial Weakness No Movement

Upload Patient Images

Upload images to document facial asymmetry (secure storage required)

*Image upload disabled in this demo for privacy reasons