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Case Reports in Pediatrics
Volume 2017, Article ID 6368239, 3 pages
Case Report

Facial Asymmetry in a Crying Newborn: A Comparison of Two Cases and Review of Literature

1Department of Neonatal-Perinatal Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
2Department of Pediatrics/Division of Neonatology, University of Texas Medical Branch Galveston, Waverley Smith Pavilion, Room 6.104, 301 University Blvd., Galveston, TX 77555-0526, USA
3Department of Pediatrics, Division of Neonatology, University of Texas Medical Branch Galveston, Research Building 6, Room 3.300, 301 University Blvd., Galveston, TX 77555-0587, USA

Correspondence should be addressed to Shreyas Arya; gro.cmhcc@ayra.sayerhs

Received 29 January 2017; Accepted 9 February 2017; Published 26 February 2017

Academic Editor: Nina L. Shapiro

Copyright © 2017 Shreyas Arya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Facial asymmetry in a crying newborn can be due to a variety of different causes. Neonatal asymmetric crying facies (NACF) is a specific phenotype, which is often underrecognized. It is defined as asymmetry of the mouth and lips with grimacing or smiling, but a symmetric appearance at rest. NACF needs to be differentiated from complete facial palsy in a newborn, which can occur due to traumatic or developmental etiologies. Developmental causes can be present in isolation or may be a part of a recognized syndrome. While asymmetric lower lip depression may be seen in both conditions, complete facial palsy is also associated with upper and mid face deformities. We present a case of NACF and compare it to a case of facial palsy due to perinatal trauma. The purpose of this case series is to clarify some of the confusing nomenclatures and highlight the differences in the physical exam findings, diagnosis, and eventual prognosis of these cases.