Three males with congenital facial palsy from 3 generations in the same family are reported from the Floating Hospital for Children, Tufts-New England Medical Center, Boston, MA. Each had a left facial palsy, more severe in successive generations. The proband, a 9-year-old male, and his father had abnormal MRI studies, with enlargement and/or enhancement of the tympanic portion of the facial nerve. Taste in the anterior two thirds of the tongue was preserved, and blink reflexes were asymmetric. EMG/nerve conduction studies confirmed the nerve palsy and showed lowered compound muscle action potential amplitudes. The etiology was undetermined. 
COMMENT. This appears to be the first report of familial congenital facial palsy. A partial agenesis of the facial nerve nucleus is considered in etiology. In the absence of an associated sixth nerve palsy, a diagnosis of Mobius syndrome is unlikely.