A child with bilateral facial nerve and abducens nerve palsy.
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Right facial nerve is hypoplastic and the left facial nerve is absent. Also, the floor of the fourth ventricle is flattened due to absence of the facial colliculus.
2 case question available
In this case, the referring Ophthalmologist already had a working diagnosis of Möbius syndrome prior to imaging. The combination of facial nerve palsy and abducens nerve palsy is characteristic, and high resolution T2 imaging should be obtained in these cases to examine the cisternal portions of the facial nerve. Although, the abducens nerve is not routinely visualized on imaging, the absence of the facial colliculi should be sought, as they are mainly formed by the abducens nerve nuclei.
- Ghabrial R, Versace P, Kourt G et-al. Möbius' syndrome: features and etiology. J Pediatr Ophthalmol Strabismus. 35 (6): 304-11. - Pubmed citation