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A 2½-month-old
boy was admitted with the complaint of fever. He was born at 40 weeks
gestation. The mother had un-complicated antenatal and perinatal
periods. Family history was non-contributory. On physical examination,
he had a vigorous cry and closed his eyes satisfactorily, and
extraocular movements were intact. The frontalis, orbicularis oculi,
zygomaticus, and mentis muscles functioned adequately, and symmetrical
face at rest was recorded (Fig. 1). When he cried, the right
corner of the mouth drew right and downward, while the left corner did
not move (Fig. 2). Palpable thinning of the left lower lip near its left
margin was noted. The patient was diagnosed as an isolated case of
asymmetric crying facies because he did not have any other abnormality
related to the other systems.
An infant whose face
appears symmetrical at rest and whose mouth is pulled downward to one
side when crying is said to have an "asymmetric crying facies".
The cause of the facial asymmetry in this disorder is congenital absence
or hypoplasia of the depressor anguli oris muscle at the corner of the
mouth. Asymmetric crying facies may be isolated or it may be associated
with various anomalies related to cardiovascular, musculoskeletal,
respiratory, gastrointestinal, central nervous system or genitourinary
systems.
Hüseyin Çaksen,
Assistant Professor in Pediatrics,
Yüzüncü Yil University Faculty of
Medicine,
Van, Turkey
E-Mail: [email protected]
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Fig. 1. Photograph of
the child
showing symmetrical face at rest. |
Fig. 2. On crying, the
mouth was pulled down and to the right due to hypoplasia of the
depressor anguli oris muscle.
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