Owecki Michał K, Kapelusiak-Pielok Magdalena, Kowal Piotr, Kozubski Wojciech
Katedra i Klinika Neurologii, Akademia Medyczna, ul. Przybyszewskiego 49, 60-355 Poznań.
Neurol Neurochir Pol. 2006 Sep-Oct;40(5):450-545.
We present a rare case of bilateral crocodile tears syndrome (CTS) in the course of Melkersson-Rosenthal syndrome. Melkersson-Rosenthal syndrome is characterised by a triad of recurrent orofacial swelling, relapsing facial paralysis, and fissured tongue. The classic triad is infrequent and oligosymptomatic variants are seen more frequently. CTS is a rare complication of facial nerve paralysis characterised by inappropriate lacrimation on the side of the palsy in response to salivary stimuli. It results from aberrant reinnervation of the lacrimal gland by salivary parasympathetic fibres. The therapeutic approach for an acute bout of Melkersson-Rosenthal syndrome consists mainly of steroid administration. CTS management is composed of anticholinergic drugs and surgical procedures. Botulin toxin injection into the lacrimal gland is the most modern therapeutic option. In the case presented CTS developed in a 50-year-old man after 5 incidents of facial palsy due to Melkersson-Rosenthal syndrome. The case deserves attention due to the rarity of the observed symptoms and signs.
我们报告了一例罕见的在梅尔克森-罗森塔尔综合征病程中出现双侧鳄鱼泪综合征(CTS)的病例。梅尔克森-罗森塔尔综合征的特征为复发性口面部肿胀、复发性面神经麻痹和裂舌三联征。典型的三联征并不常见,而症状较少的变异型更为常见。CTS是面神经麻痹的一种罕见并发症,其特征为在唾液刺激时,麻痹侧出现不适当的流泪。它是由唾液副交感神经纤维对泪腺的异常再支配引起的。梅尔克森-罗森塔尔综合征急性发作的治疗方法主要包括使用类固醇。CTS的治疗包括使用抗胆碱能药物和手术治疗。向泪腺注射肉毒毒素是最现代的治疗选择。在本病例中,一名50岁男性在因梅尔克森-罗森塔尔综合征发生5次面神经麻痹后出现了CTS。由于所观察到的症状和体征较为罕见,该病例值得关注。