A Rare Triad of Congenital Facial, Abducens, and Hypoglossal Nerve Palsies: A Case Report

Moebius syndrome is a rare congenital neurological disorder characterized primarily by nonprogressive facial and abducens nerve palsy. Involvement of additional cranial nerves is uncommon. We describe an eight-year-old boy presenting with left-sided facial nerve palsy, hypoglossal nerve atrophy, and absence of the abducens nerve. Clinical examination revealed facial deviation, restricted ocular abduction, tongue atrophy, and feeding and speech difficulties - features consistent with a mild Moebius spectrum. MRI demonstrated hypoplasia of the left facial nerve, absence of the left abducens nerve, and atrophy of the right half of the tongue, confirming hypoglossal involvement. This case underscores the importance of early recognition and detailed MRI evaluation to detect atypical cranial nerve anomalies in children with Moebius syndrome.