House-Brackmann grading system

The House-Brackmann grading system is used to grade facial nerve paralysis as follows:

  • Grade I – Normal
  • Grade II – Mild dysfunction, slight weakness on close inspection, normal symmetry at rest
  • Grade III – Moderate dysfunction, obvious but not disfiguring difference between sides, eye can be completely closed with effort
  • Grade IV – Moderately severe, normal tone at rest, obvious weakness or asymmetry with movement, incomplete closure of eye
  • Grade V – Severe dysfunction, only barely perceptible motion, asymmetry at rest
  • Grade VI – No movement

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