Labour and delivery: neonatal facial nerve palsy: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Labour and delivery: neonatal facial nerve palsy

Sample item

A newborn delivered with forceps shows asymmetry on crying: the mouth draws towards the left, the right eye does not close fully and the right forehead cannot be wrinkled. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Peripheral right facial nerve palsy

A forceps blade or the maternal sacral promontory can compress the facial nerve near the stylomastoid foramen. A lower motor neurone lesion paralyses the whole half of the face, including the forehead and the eyelid closure. It usually recovers spontaneously within weeks.

Option by option

  • A. Peripheral right facial nerve palsy (correct)

    Correct. Involvement of the forehead and eye closure indicates a peripheral lesion.

  • B. Hypoglossal nerve palsy

    Hypoglossal palsy deviates the tongue and does not alter the face.

  • C. Central facial palsy from intracranial haemorrhage

    A central lesion spares the forehead because of bilateral upper-face innervation.

  • D. Congenital hypoplasia of the depressor anguli oris

    Hypoplasia of one lip muscle affects only the mouth and spares the forehead and eye.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Peripheral right facial nerve palsy. A forceps blade or the maternal sacral promontory can compress the facial nerve near the stylomastoid foramen.

Why is "Hypoglossal nerve palsy" not the answer?

Hypoglossal palsy deviates the tongue and does not alter the face.

Why is "Central facial palsy from intracranial haemorrhage" not the answer?

A central lesion spares the forehead because of bilateral upper-face innervation.

Why is "Congenital hypoplasia of the depressor anguli oris" not the answer?

Hypoplasia of one lip muscle affects only the mouth and spares the forehead and eye.

What concept does this question test?

It tests Labour and delivery: neonatal facial nerve palsy in OBG. A lower motor neurone lesion paralyses the whole half of the face, including the forehead and the eyelid closure. It usually recovers spontaneously within weeks.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Labour and delivery: neonatal facial nerve palsy?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.