PAROXYSMAL LACRIMATION (SYNDROME OF CROCODILE TEARS) AND ITS SURGICAL TREATMENT

Abstract

THE PHENOMENON of unilateral tearing during eating has been called paroxysmal lacrimation. According to legend, the crocodile was believed to weep hypocritical tears while devouring its victims; therefore Bogorad¹termed the condition "syndrome of crocodile tears." This rare syndrome occurs oftenest as a sequel of facial nerve palsy. Ford²has shown that it cannot follow the commoner form of Bell's palsy, in which the lesion is distal to the geniculate ganglion; it can occur only in those cases in which the lesion is in or proximal to the ganglion. Moreover, the syndrome does not develop until the motor paralysis has disappeared. A theory of its mechanism has been described but not proved, and a permanent means of relief to patients having the syndrome has not been devised. In this presentation, the theory is supported that the phenomenon is due to the misdirection of regenerating nerve fibers, and a