Causes of Facial Paralysis
Mobius (Moebius) Syndrome
Professor Paul Julius Möbius
Professor Paul Julius Möbius was the first physician to describe this rare disease in 1884. Mobius syndrome typically affects cranial nerve 6 and 7 resulting in facial and eye muscle movement disorders. Other cranial neuropathies may also occur. Limb anomalies such as club foot can also occur in up to 25% of the patients. This rare syndrome is typically bilateral but can have asymmetric presentation with one side having some limited movement.Facial paralysis is the most overt symptom related to Mobius syndrome. Children’s facial expression and function are impaired with an inability to suck and smile. Furthermore, the patients have strabismus and present with significant drooling and mask-like appearance
The treatment options for facial reanimation should be considered before the children enter school. For bilateral facial paralysis, the treatment of choice at The Institute for Facial Paralysis is microsurgical trigeminal-gracilis muscle transfer. This procedure involved transfer of the gracilis muscle (from the inner thigh) to the face and attachment to the trigeminal nerve which controls the muscles for chewing. This muscle and nerve transfer allows the children to control the movement of the face voluntarily. Each side of the face must be performed in separate stages. Typically the first operation is performed when the child has turned 6. The second stage is performed at age 7. The psychosocial implications for surgical reanimation are very important.
Other surgical procedures that can be considered are static suspension with tensor fascia lata, temporalis transfer and eyelid reconstruction.
