Moebius Syndrome is a fairly rare neurological disorder that is present at birth. Children born with this condition are unable to move the muscles in their faces, leaving them unable to smile or frown, blink, or even move their eyes. Moebius primarily affects the 6th and 7th cranial nerves, but may also affect the 3rd, 4th, 5th, 9th, 10th, or the 12th cranial nerves as well.
Moebius Syndrome was first described as congenital facial diplegia in 1880 by Von Graefe, but was later reviewed by Paul Julius Mobius in 1888 and again in 1892. Mobius was a German Neurologist who ultimately, because of his review of the disease, had the honor of having the condition named after him.
The primary event or cause of Moebius has not been clearly defined, although it does involve the nerves and brainstem of the affected person and may also include muscle aplasia. There are varying definitions and diagnosing criteria for Moebius Syndrome. According to von Graefe and Mobius, cases that include congenital facial diplegia and bilateral abducens nerve palsies fit the criteria as Moebius Syndrome. However, in 1939 the definition was expanded to include cases that contained congenital unilateral facial palsy. It is believed that Moebius Syndrome is degenerative and involves the nuclei of the affected nerves. In contrast to this theory, it is suggested that it is an inherited condition that involves the disruption of blood flow in the basilar artery; or, a disruption of the subclavian artery supply which interrupts the blood supply to the embryo.
There is evidence that Moebius syndrome is an inherited condition, but again, it’s exact cause is still unknown. Genetic counseling is recommended for parents where either the mother or father is affected. However, prenatal testing for affected parents is not currently available.
Some issues that Moebius sufferers face aside from the inability to move facial muscles include:
*Issues with feeding and swallowing
*Sensitivity of the eyes due to the inability to squint.
*Motor delays
*Crossing of the eyes (strabismus)
*Drooling
*Short or deformed tongue
*Hearing complications
*Speech disorders
*Club feet
*Midline, hand, and/or feet deformities
Specialized bottles or feeding tubes are available for babies with Moebius who have difficulty feeding. Some children with speech problems due to the impaired ability to move their tongue and lips are able to have this corrected, or at least improved, through speech therapy. As they get older, the inability to smile becomes the most prominent symptom and issue through preteen and teenage years.
In addition to speech therapy as a source of treatment for Moebius patients, physical therapy may also help to improve gross motor skills. Surgery may be required to improve deformities of the jaw or deformities of the hands or limbs. In recent years, some patients who have wanted the ability to smile opted to have surgery to transfer working nerves to the corners of their mouth.
Aside from the affects of Moebius Syndrome, affected individuals are able to live very normal lives. While some do opt for surgeries to help them show some of the same emotions that many of us show on a regular basis, others are very comfortable and accepting of their differences.
