If cranial nerve VIII is affected, the person experiences hearing loss.Other symptoms that sometimes occur with Möbius syndrome are:
Limb abnormalities—clubbed feet, missing fingers or toes
Chest-wall abnormalities (Poland syndrome)
Crossed eyes (strabismus)
Difficulty in breathing and/or in swallowing
Corneal erosion resulting from difficulty in blinkingChildren with Möbius syndrome may have delayed speech because of paralysis of muscles that move the lips, soft palate and tongue root. However, with speech therapy, most people with Möbius syndrome can develop understandable speech. Möbius syndrome has been associated with increased occurrence of the symptoms of autism. Some children with Möbius syndrome are mistakenly labeled as intellectually disabled because of their expressionless faces, strabismus and frequent drooling. Social and lifestyle effects
Möbius syndrome does not prevent individuals from experiencing personal and professional success. Due to the importance of facial expression and smiling in social interaction, the inability to form either can lead to individuals with Möbius being perceived as unhappy, unfriendly or uninterested in conversations. Individuals who are familiar with Möbius patients such as family or friends can recognize other signals of emotion such as body language, to the point that they sometimes report forgetting that the person has facial paralysis. Indeed, people with Möbius syndrome are often adept at compensating for a lack of expression by using body language, posture, and vocal tone to convey emotion. Pathogenesis
Möbius syndrome results from the underdevelopment of the VI and VII cranial nerves. The VI cranial nerve controls lateral eye movement, and the VII cranial nerve controls facial expression.The causes of Möbius syndrome are poorly understood.
The mouth and lips may tend to get dry with the Möbius patient. Lack of a good oral seal (lips together) allows the gingiva (gums) to get dry and may get inflamed and irritated. Permanent dentition
After the last primary tooth is lost, usually around the age of twelve, final orthodontic treatment can be initiated. A patient that has not been able to close or swallow well probably will have an open bite, deficient lower-jaw growth, a narrow archform with crowded teeth, and upper anterior flaring of teeth. Orthognathic (jaw) surgery may be indicated. This should be completed in most situations before the smile surgery where the gracilis muscle is grafted to the face.Genetic links to 13q12.2 and 1p22 have been suggested. Diagnosis
Diagnosis is typically made by the physical characteristics and symptoms, patient history and a thorough clinical evaluation. There is no specific diagnostic test that confirms Möbius syndrome. Some specialised tests may be carried out to rule out other causes of facial palsy. Treatment
There is no single course of medical treatment or cure for Möbius syndrome. Treatment is supportive and in accordance with symptoms. If they have difficulty nursing, infants may require feeding tubes or special bottles to maintain sufficient nutrition. Physical, occupational, and speech therapy can improve motor skills and coordination and can lead to better control of speaking and eating abilities. Often, frequent lubrication with eye drops is sufficient to combat dry eye that results from impaired blinking. Surgery can correct crossed eyes, protect the cornea via tarsorraphy, and improve limb and jaw deformities.