ABSTRACT

Möbius syndrome is a rare congenital and non-progressive bilateral or unilateral facial nerve palsy and ocular muscle disorder that occurs in the transverse plane (abducens nerve palsy). It can also be associated with multiple cranial nerve disorders, cardiovascular malformations, intellectual disorders, musculoskeletal deformities, and peripheral neuropathy. In this case study, a 28-month old male child diagnosed with Möbius syndrome showing vomiting, a sucking disorder, small mandible, and dysphagia was referred to an occupational therapist for developmental evaluation and dysphagia assessment. The child demonstrated ptosis, had difficulty closing his mouth due to an elevated upper lip, and had abnormally low-positioned ears and an expressionless face. After the evaluation, it was determined that the child was developmentally delayed with low scores in mental development index and psychomotor development index based on the Bayley scales of infant development II. Additionally, a severe language development delay was indicated based on the sequence language scale for infants. Based on a video fluoroscopy dysphagia evaluation of the child, aspiration was observed in a thin liquid form, and a delayed swallowing reflex was also detected. Since Möbius syndrome has not yet been presented in the field of occupational therapy in Korea, the authors reviewed the literature and presented this case study in order to share their evaluation process and occupational therapy intervention method for children with this syndrome.