A newborn has bilateral inability to close the eyes, absent facial expression bilaterally, and failure of lateral gaze in both eyes. The rest of the neurological examination is appropriate for age. The most likely diagnosis is:

• A Neonatal Guillain-Barre syndrome
• B Klumpke's birth palsy
• C Congenital myotonic dystrophy
• D Mobius syndrome ✓

Explanation

Mobius syndrome is a congenital condition characterised by bilateral non-progressive facial diplegia combined with bilateral abducens (sixth nerve) palsy, giving the classic mask-like face with impaired horizontal gaze. Klumpke's palsy affects the lower brachial plexus causing a claw hand, not cranial nerves. Neonatal Guillain-Barre would show generalised hypotonia and areflexia rather than isolated sixth and seventh cranial nerve palsies present from birth.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.