Quiz 24: 6 yo with asymmetric smile

 This 6 year old has had an asymmetric smile/cry since birth. Although covered in the picture, she had symmetric eye closure. (Images with courtesy from Prof Essam AL-Zwaini)


1) What is the condition?
2) If on auscultation you heard a grade 4/6 holosystolic murmur in the left parasternal area radiating across the sternum what syndrome would you diagnose her with?

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7 comments:

Dr.D.Sudhakar October 18, 2010 at 2:51 AM  

Quiz 24:6 yo with asymmetric smile

The description holds good for congenital unilateral facial palsy.

In congenital absence of depressor anguli oris muscle (Hufnagel's palsy), child is unable to retract corner of the mouth only.

Anonymous October 19, 2010 at 12:37 AM  

Congenital unilateral facial palsy would mostly be infranuclear. Supranuclear is theoretically possible, but very rare in isolation.

Sun October 19, 2010 at 5:57 AM  

Shekeebus-Thanks for explaining.

Dr. Sudhakar-If she had facial palsy, as shekeebus mentioned it would be LMN type and hence would not have symmetric eye closure.

Anonymous October 19, 2010 at 3:35 PM  

Central right facial palsy

Dr.D.Sudhakar October 21, 2010 at 2:04 AM  

Thank you shekeebus and sun.
Why did I read it as asymmetric eye closure? I was probably absent-minded.

Anonymous January 19, 2011 at 8:39 AM  

congenital absence of depressor anguli oris muscle

J August 1, 2011 at 11:30 AM  

Hawthorne Syndrome

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