31/5/2014

House-Brackmann scale

House-Brackmann scale
2013 UpToDate
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House-Brackmann classification of facial nerve dysfunction
Grade
Characteristics
I. Normal
Normal function in all areas
Gross
Slight weakness noticeable on close inspection
May have slight synkinesis
Normal symmetry and tone at rest
II. Mild dysfunction
Motion
Forehead: Moderate to good function
Eye: Complete closure with minimal effort
Mouth: Slight asymmetry
Gross
Obvious but not disfiguring difference between the two sides
Noticeable but not severe synkinesis, contracture, or hemifacial spasm
Normal symmetry and tone at rest
III. Moderate dysfunction
Motion
Forehead: Slight to moderate movement
Eye: Complete closure with effort
Mouth: Slightly weak with maximum effort
Gross
Obvious weakness and/or disfiguring asymmetry
Normal symmetry and tone at rest
IV. Moderately severe dysfunction Motion
Forehead: None
Eye: Incomplete closure
Mouth: Asymmetric with maximum effort
Gross
Only barely perceptible motion
Asymmetry at rest
V. Severe dysfunction
Motion
Forehead: None
Eye: Incomplete closure
Mouth: Slight movement
VI. Total paralysis
No movement

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