House-Brackmann classification of facial nerve dysfunction

Grade	Characteristics
I. Normal	Normal function in all areas
II. Mild dysfunction	Gross
	Slight weakness noticeable on close inspection
	May have slight synkinesis
	Normal symmetry and tone at rest
	Motion
	Forehead: Moderate to good function
	Eye: Complete closure with minimal effort
	Mouth: Slight asymmetry
III. Moderate dysfunction	Gross
	Obvious but not disfiguring difference between the two sides
	Noticeable but not severe synkinesis, contracture, or hemifacial spasm
	Normal symmetry and tone at rest
	Motion
	Forehead: Slight to moderate movement
	Eye: Complete closure with effort
	Mouth: Slightly weak with maximum effort
IV. Moderately severe dysfunction	Gross
	Obvious weakness and/or disfiguring asymmetry
	Normal symmetry and tone at rest
	Motion
	Forehead: None
	Eye: Incomplete closure
	Mouth: Asymmetric with maximum effort
V. Severe dysfunction	Gross
	Only barely perceptible motion
	Asymmetry at rest
	Motion
	Forehead: None
	Eye: Incomplete closure
	Mouth: Slight movement
VI. Total paralysis	No movement

Graphic 70562 Version 2.0