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. [1]

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.