HISTORY
This 1-week-old baby boy was brought for his first newborn visit. The parents were concerned that when he cried, the left side of his face “does not move”.
He was born at full term via normal vaginal delivery to a primigravida without complications. Weight was 3.47 kg. Apgar scores, 9 and 9 at 1 and 5 minutes. Pregnancy and prenatal course were uneventful. Mother denied history of uterine tumors, multiple gestation, or polyhydramnios. No family history of neurological disorders or genetic syndromes.
PHYSICAL EXAMINATION
Vital signs normal. Weight, 3.51 kg; length, 49.5 cm; and head circumference, 34 cm. At rest, the infant's facial features appeared symmetric (A), with no bruising or obvious trauma.
When he cried, the lower lip on the left side did not depress, the left eyelids remained open, the forehead and eyebrow did not wrinkle, and the nasolabial fold on the left was flat (B).
He had normal suck and swallow reflexes and did not drool.
Mild positional plagiocephaly was noted in the right parietal area. Anterior fontanelle open, 2 × 2 cm, and pulsatile. Red reflexes intact bilaterally, with no obvious retinal hemorrhages. Two small subconjunctival hemorrhages noted in the right eye were coalescing around the iris and appeared to be of no clinical significance.
WHAT'S YOUR DIAGNOSIS?
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