The Sunnybrook Facial Grading System (SFGS) is one of the most employed scales 
to assess the severity of facial palsy. The aim of our study was to produce an 
Italian version of the SFGS and of its explanatory criteria, and to test their 
measurement properties when employed by Italian physicians. A multidisciplinary 
committee translated and adapted the scale and its criteria into Italian. Six 
native Italian physicians, four of whom experienced in facial palsy and two 
novices, rated independently 29 videos of facial palsy patients twice. Internal 
consistency, agreement and repeatability were evaluated. The Italian version of 
the SFGS showed a high degree of internal consistency with a Cronbach's α of 
0.91. The test-retest reliability was high for both inter-rater and intra-rater 
measures with an ICC of 0.96 and 0.98, respectively. The scores given by the 
novice physicians were comparable with the scores given by the expert 
physicians. Our study suggests that the Italian version of the SFGS has 
excellent internal consistency and reproducibility, comparable to the original 
scale. Our study confirms in an independent case record the high measurement 
properties of SFGS and provides the first validated Italian scale for the 
assessment of facial palsy.