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House-Brackmann facial nerve grading system
Grade I - Normal
Normal facial function in all areas
Grade II - Slight Dysfunction
Gross: slight weakness noticeable on close inspection; may have very slight synkinesis
At rest: normal symmetry and tone
Motion: forehead - moderate to good function; eye - complete closure with minimum effort; mouth - slight asymmetry.
Grade III - Moderate Dysfunction
Gross: obvious but not disfiguring difference between two sides; noticeable but not severe synkinesis, contracture, and/or hemi-facial spasm.
At rest: normal symmetry and tone
Motion: forehead - slight to moderate movement; eye - complete closure with effort; mouth - slightly weak with maximum effort.
Grade IV - Moderate Severe Dysfunction
Gross: obvious weakness and/or disfiguring asymmetry
At rest: normal symmetry and tone
Motion: forehead - none; eye - incomplete closure; mouth - asymmetric with maximum effort.
Grade V - Severe Dysfunction
Gross: only barely perceptible motion
At rest: asymmetry
Motion: forehead - none; eye - incomplete closure; mouth - slight movement
Grade VI - Total Paralysis
No movement
Reference
House JW, Brackmann DE. Facial nerve grading system. Otolaryngol. Head Neck Surg 1985; 93: 146–147.