House Brackmann

Grade I

Normal: symmetric appearance and function in all areas

Grade II

Slight dysfunction: only noticeable on close inspection. Normal symmetry and tone at rest.
• Forehead: moderate to good function
• Eye closure: complete with minimal effort
• Mouth closure: slight asymmetry

Grade III

Moderate dysfunction: obvious, but not disfiguring asymmetry. Normal symmetry and tone at rest.
• Forehead: slight to moderate movement
• Eye closure: complete with effort
• Mouth closure: slight weakness with maximal effort

Grade IV

Moderately severe dysfunction: obvious weakness with possible dysfunction
• Forehead: no motion
• Eye closure: incomplete
• Mouth closure: asymmetric with maximal effort

Grade V

Severe dysfunction: only minimal motion-asymmetry at rest
• Forehead: no motion
• Eye closure: incomplete
• Mouth closure: slight movement only

Grade VI

Complete paralysis: no movement at any level, obvious asymmetry at rest

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