Facial Nerve

Clinical grading of facial nerve function (House and Brackmann)

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