Moebius syndrome with Dandy-Walker variant and agenesis of corpus callosum
A 15-month-old male child 4th born to second degree consanguineous parents by spontaneous vaginal delivery, presented with inability to close his right eye, drooling of saliva, difficulty in sucking, and deviation of the face to the left since birth. This was in the background of global developmental delay and at present he can sit with support, does not progress beyond cooing with normal vision and hearing deficit [].\nOn examination, he has Grade III protein energy malnutrition (PEM) with his weight falling below 3rd percentile according to World Health Organization growth chart, length was between the 3rd and 25th percentile and his head circumference was appropriate for his length according to Dines formula. On examination he is conscious, playful, oriented to person. Cranial nerve examination reveals bilateral abducen nerve palsy and right-sided facial nerve palsy, as he was unable to blink his right eye with loss of angle of mouth on the right side and deviation of the mouth to the left. He has bilateral hearing loss which was confirmed with brainstem evoked response audiometry. The metabolic screening test, serum lactate, and ammonium were within normal limit.\nWith the clinical features the diagnosis of Moebius syndrome was entertained and neuroimaging was ordered as to rule out other abnormalities. The magnetic resonance imaging MRI of the brain showed complete agenesis of the corpus callosum with inferior vermian hypoplasia with prominent fourth ventricle which is consistent with the Dandy-Walker variant [].