Special Needs

Anyone else have a child with Asymmetric Cry Face?

I posted this question many months ago and didn't get much of a response, so I thought I'd try again. My son was born with ACF. His pediatrician initally dismissed it as an anomoly; said it "used to be" considered a marker for more serious complications, namely heart conditions. However, he said he didn't consider that valid research. Being a mommy with access to Google, I did my own digging and found recent publications that argue it is associated with heart defects, as well as other things. I brought it to the attention of the pediatrician, and he reluctantly agreed to do further tests to look for something else... but kind of guilted me into feeling like I was looking for something to worry about. I decided not to do any further testing.

My son is a year old now, and a recent picture (see below) I took of him reminded me that this never goes away... and makes me wonder if there is something lurking beneath the surface. My question to you is whether your pediatrician suggested further testings/screenings, and whether in your case ACF was indicitive or associated with other conditions. I'm trying to decide if I want to raise the issue again for further testing, if nothing else, for my peace of mind. Thanks ladies:)

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Re: Anyone else have a child with Asymmetric Cry Face?

  • I have no advice, but I wanted to say I would have never ever noticed an issue here in any way. I would have just chalked it up to a cute sad face. Im sorry there is a need for worry! I hope you get your answers and peace of mind soon!

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  • imageshakes:
    I have no advice, but I wanted to say I would have never ever noticed an issue here in any way. I would have just chalked it up to a cute sad face. Im sorry there is a need for worry! I hope you get your answers and peace of mind soon!

    I agree. I didn't notice anything when he was born, but the drs were all huddled around him and they brought in a specialist to see him right away to confirm the diagnosis... then the pedi was all, oh it's nothing to worry about. To me, it just looks like a crooked little smile/cry; not a "marker" for anything serious.

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  • I think I may have answered you before. Nate has ACF but it also affects his eyes too. One squishes up more when he cries. Here is a picture from when he was 4 months old...

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    I googled it as well. Nate has a lot of other things going on along the midline of his body due to micro-deletions on his chromosome #1. He did have a large PDA at birth that has resolved and we also followed up with a cardiologist. There was nothing else found.

    Nate's neuro has noted that it appears that Nate has some damage to his 7th nerve. This is probably related to one of his chromosome deletions. The 7th nerve is in the same area as the auditory nerve and Nate is also hard of hearing. His hearing is worse on the left side, but I am not sure if they are too connected because the weakness in his face is on the right side. *shrugs*

    I have a bit of a "winky face" when I smile. The right eye is open more than the other. So it is also possible that part of this presentation comes from me. Again *shrugs*

    I think if you want to have a piece of mind ask for a referral to a cardiologist and have an EKG done. Your pedi probably doesn't hear a murmur and this is why he/she is not concerned. If all other milestones are being met and there is no other presentation than a ACF, then I wouldn't borrow trouble. Good Luck!

    WAY 2 Cool 4 School


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  • Emma doesn't have ACF, but if I were me, I'd go with my Mommy Instincts and get further testing.  There's a reason they're called Mommy Instincts...
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  • I agree with previous posters - for your own piece of mind, I'd probably want to follow up with a cardiologist.  Our geneticist noticed my son's ACF at our first appt with her but by then we already knew about his heart issues because he had a murmur from birth....
  • My son has ACF. When he was born they said it was a pinched nerve and that it would go away by 8 weeks. When it didn't, I googled and then told my pedi what I had found. She admitted that she knew very little about ACF and referred me to a neurologist.

    He was about 6 mo. by the time we got in to see the neuro. He played with Jude some and looked for traits that go along with Cayler syndrome just to rule that out. He couldn't find anything other than the ACF (which was great). He then referred us to a cardiologist for diagnostic evals just to rule out any heart issues. So last week we had a chest xray and an EKG. It turns out that he has a very faint murmur (cardio said it wouldn't be heard by an untrained ear like the regular pedi), but the murmur probably isn't even associated with ACF.

    Anyway, all of that is just to tell you the course of referrals that we sought out. Everything has turned out to be fine, but I absolutely think it was worth it just for that peace of mind. :)

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