House-Brackmann Facial Nerve Grading

When it activates

Scribeable activates a calculator from the encounter. The House-Brackmann Facial Nerve Grading can activate when the transcript or pasted chart context documents any of these:

• Facial nerve assessment
• Bell palsy evaluation
• Post-parotid surgery nerve function
• Facial paralysis grading

Inputs the note needs

1 input. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.

Scoring

I=Normal, II=Slight dysfunction, III=Obvious but not disfiguring, IV=Obvious weakness/disfiguring asymmetry, V=Barely perceptible motion, VI=Total paralysis.

Interpretation

I: Normal. II: Slight weakness on close inspection. III: Obvious but not disfiguring — eye closure complete. IV: Obvious weakness — incomplete eye closure. V: Barely perceptible motion. VI: Total paralysis.

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: House & Brackmann 1985.

• House JW, Brackmann DE. Facial nerve grading systemHouse & Brackmann (Facial Nerve) 1985 · 1985 · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the House-Brackmann Facial Nerve Grading at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.

The score is computed in code from the resolved inputs, not recalled by the language model. A stated House-Brackmann Facial Nerve Grading value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.

Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.

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Can activate in: Neurology, ENT / Otolaryngology, Neurosurgery.