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October 1968

Poverty of Facial Function Associated With Brain DamageA Clinical Sign and Obstacle to Nonverbal Relationship

Author Affiliations

From the Pennsylvania Hospital, Philadelphia, and the University of Pennsylvania School of Medicine.

Arch Gen Psychiatry. 1968;19(4):491-496. doi:10.1001/archpsyc.1968.01740100107015

IN THE clinical evaluation and care of a group of brain-damaged subjects we have noted the failure of a significant number to mobilize facial movement adequately, and we suggest that this deficit may be used as an important clinical sign in the diagnosis of brain injury. Further, we have postulated from our observations that certain accompanying aberrant behavior often observed with brain-damaged individuals may be conceived as consequential to neuropathological interference with the motor aspects of nonverbal interaction; this interference, we suggest, particularly involves facial function, the central modality, in our view, of nonverbal interaction.1

Description of the Disability  The disability varies from a nearly total immobility of facial expression to what seems best described as a failure to sustain expression sufficiently. With the latter, for instance, a smile instead of being sustained for a period and then gradually changed to a neutral but alert expression, will quickly

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