FYI
re baby with ? Palsy ?absence of depressor angularis
http://makeashorterlink.com/?R1F264AF4
(hope the link works)
I found this interesting article in the British journal of Plastic Surgery
British Journal of Plastic Surgery (1998), 51, 138-141
© 1998 The British Association of Plastic Surgeons
.........."The most common cause of congenital facial palsy is birth trauma. Falco et al reported that 88% of all cases with congenital facial nerve palsy were related to birth trauma.1 In addition to birth trauma, there are diseases such as Möbius syndrome,2 hemifacial microsomia and congenital unilateral lower lip palsyCULLP).3,4
Möbius syndrome (congenital facial diplegia syndrome), is a congenital bilateral facial nerve palsy and first described in 1988.5 It is commonly associated some other congenital disorder, in particular, the abducent nerve tends to be affected.6 The cause of Möbius syndrome has been considered to be hypoplasia the facial nucleus, but this remains questionable because various muscles and bones are also commonly affected. Bavinck hypothesized that the cause Möbius syndrome could be an interruption of the embryonic blood supply in the vertebral arteries their branches, followed by ischaemia or necrosis cranial nuclei VI and VII.7 He concluded that if ischaemia were to occur at multiple sites, complex disorders could develop. Hemifacial microsomia originates in hypoplasia of the first and second branchial arches, which is characterised by microtia. It occasionally involves hemifacial nerve palsy. Although diagnosed as "hemifacial microsomia", 10-20% of are bilaterally affected. CULLP is also called congenital hypoplasia of the depressor anguli oris muscle (DOAM). CULLP has acharacteristic face - the unilateral palsy of the lower only evident when the patient cries. In general, its is considered to be hypoplasia of the depressor anguli oris muscle or the depressor labii inferioris muscle.3,4 But CULLP cannot be considered to beexclusively myogenic because it sometimes accompanies cardiac or other facial abnormalities including microtia.11 Furthermore, it has not been clarified pathologically. Partial absence of facial muscles is rare except in CULLP. Only two cases have been reported before.8 In one, both the left frontalis and orbicularis oculi muscles were affected and in the other case, only the left frontalis muscle was affected. Surgical treatments for these diseases are also uncommon.9 This may be because the patients with CULLP show no abnormal features at rest, and cry less often as they grow up. One case has also been reported to show spontaneous improvement.10
We believe that the diseases described above overlap each other11 because they entail a similar complex of anomalies and their origins are still uncertain.12 Additional studies are essential to clarify their relationships. ....."
and in case you were wondering what microtia is (like i was).......
http://www.microtia.com/whatis.html
The term microtia indicates a small, abnormally shaped or absent external ear. It can occur on one side only (called "unilateral") or on both sides (called "bilateral"). The unilateral form is much more common, occurring in approximately 90% of patients.
Regards
Karen Clements
IBCLC Melb Aust
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