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Clinical Pediatrics
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Neonatal Asymmetric Crying Facies: A New Look at an Old Problem

Samuel O. Sapin, MD

David Geffen School of Medicine at UCLA, Los Angeles, Department of Pediatrics, So. Cal. Permanente Medical Group, Panorama City, California

Alvin A. Miller, MD

David Geffen School of Medicine at UCLA, Los Angeles, Department of Pediatrics, So. Cal. Permanente Medical Group, Panorama City, California

Harold N. Bass, MD

David Geffen School of Medicine at UCLA, Los Angeles, Department of Pediatrics, So. Cal. Permanente Medical Group, Panorama City, California

Neonatal asymmetric crying facies, described 75 years ago, is a clinical phenotype resembling unilateral partial peripheral facial nerve paralysis, with an incidence of approximately 1 per 160 live births. The cause is either facial nerve compression or faulty facial muscle and/or nerve development. Spontaneous resolution is expected with the former, but not necessarily with the latter etiology. Approximately 10% of the developmental cases have associated major malformations. Mandibular asymmetry and maxillary-mandibular asynclitism (non-parallelism of the gums) are frequently overlooked visual clues to nerve compression. Ultrasound imaging of facial muscles and electrodiagnostic testing may be useful for differential diagnosis and management.

Clinical Pediatrics, Vol. 44, No. 2, 109-119 (2005)
DOI: 10.1177/000992280504400202
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