Mobius Syndrome

Mobius syndrome, a rare genetic disorder characterized by facial paralysis, is caused by the absence or underdevelopment of the 6th and 7th cranial nerves. These nerves control eye movements and facial expression.

In newborns, the first symptom is an inability to suck. Excessive drooling and strabismus (crossed eyes) may occur. Other symptoms may include lack of facial expression; inability to smile; feeding, swallowing, and choking problems; eye sensitivity; motor delays; high or cleft palate; hearing problems; and speech difficulties. Deformities of the tongue, jaw, and limbs, such as club foot and missing or webbed fingers, may also occur.

Most patients have low muscle tone, especially in the upper body. Mental retardation may also occur. As children get older, lack of facial expression and inability to smile become the dominant visible symptoms.

Mobius syndrome may be accompanied by Pierre Robin syndrome, a disease in which there is an abnormally small jaw, downward displacement of the tongue, and a soft, cleft palate. It may also be accompanied by Poland's anomaly, a disease characterized by abnormal development of one side of the chest and limb deformities.

There is no specific course of treatment for Mobius syndrome. Treatment is supportive and symptomatic. Infants may require feeding tubes or special bottles to maintain sufficient nutrition. Surgery may correct strabismus and improve limb and jaw deformities. Physical and speech therapy may improve motor skills and coordination, and help to better control speaking and eating abilities.

Plastic reconstructive surgery may be beneficial in some individuals. Also, in a few cases, nerve and muscle transfers (microvascular muscle transplant) to the corners of the mouth have been performed to provide some ability to smile.

There is no cure for Mobius syndrome. With proper care and treatment many individuals have normal life expectancy, in spite of the severe impairments that characterize the disorder.

Information provided by the
National Institute of Neurological Disorders and Stroke,
National Institutes of Health

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.