Facial Nerve

1. Clinical grading of facial nerve function (House and Brackmann)

Grade	Function Description
1	normal facial function in all areas
2	mild dysfunction 1. gross: slight weakness noticeable on close inspection; may have very slight synkinesis 2. at rest: normal symmetry and tone 3. motion:  a) forehead: slight to moderate movement  b) eye: complete closure with effort  c) mouth: slight asymmetry
3	moderate dysfunction 1. gross: obvious but not disfiguring asymmetry; noticeable but not severe synkinesis 2. motion:  a) forehead: slight to moderate movement  b) eye: complete closure with effort  c) mouth: slightly weak with maximal effort
4	moderate to severe dysfunction 1. gross: obvious weakness and/or disfiguring asymmetry 2. motion:  a) forehead: none  b) eye: incomplete closure  c) mouth: asymmetry with maximum effort
5	severe dysfunction 1. gross: only barely perceptible motion 2. at rest: asymmetry 3. motion:  a) forehead: none  b) eye: incomplete closure
6	total paralysis no movement