Have you hurriedly concluded that someone you've never seen smiling is unfriendly or wicked? Wait a minute you might be mistaken as such a person might have Moebius syndrome.
It is a rare congenital neurological disorder which is characterized by facial paralysis and the inability to move the eyes from side to side. Most people with Moebius syndrome are born with complete facial paralysis and cannot close their eyes or form facial expressions. Limb and chest wall abnormalities sometimes occur with the syndrome. People with Moebius syndrome have normal intelligence, although their lack of facial expression is sometimes incorrectly taken to be due to dullness or unfriendliness. It is named for Paul Julius Moebius, a German neurologist who first described the syndrome in 1888.

People with Moebius syndrome are born with facial paralysis and the inability to move their eyes laterally. Often, their upper lip is retracted due to muscle shrinkage. Occasionally, the cranial nerves V and VIII are affected. If cranial nerve VIII is affected, the person experiences hearing loss.

Other symptoms that sometimes occur with Moebius syndrome are:

-Limb abnormalities—clubbed feet, missing fingers or toes
-Chest-wall abnormalities (Poland syndrome)
-Crossed eyes (strabismus)
-Difficulty in breathing and/or in swallowing
-Corneal erosion resulting from difficulty in blinking

Children with Moebius syndrome may have delayed speech because of paralysis of muscles that move the lips, soft palate and tongue root. However, with speech therapy, most people with Moebius syndrome can develop understandable speech. Möbius syndrome has been associated with increased occurrence of the symptoms of autism. Some children with Moebius syndrome are mistakenly labeled as intellectually disabled because of their expressionless faces, strabismus and frequent drooling.

Treatment is supportive and in accordance with symptoms. If they have difficulty nursing, infants may require feeding tubes or special bottles to maintain sufficient nutrition. Physical, occupational, and speech therapy can improve motor skills and coordination and can lead to better control of speaking and eating abilities. Often, frequent lubrication with eye drops is sufficient to combat dry eye that results from impaired blinking. Surgery can correct crossed eyes, protect the cornea via tarsorraphy, and improve limb and jaw deformities. Sometimes called smile surgery by the media, muscle transfers grafted from the thigh to the corners of the mouth can be performed to provide the ability to smile. Although "smile surgery" may provide the ability to smile, the procedure is complex and can take twelve hours for each side of the face. Also, the surgery cannot be considered a "cure" for Moebius syndrome, because it does not improve the ability to form other facial expressions.
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