[Crocodile tears syndrome].

Among 245 patients with peripheral facial nerve paralysis in 16 cases gustatory lacrimation was observed to remain as a sequel of paralysis. On the basis of clinical observation, testing of nerve excitability, Schirmer's test, examination of taste and laryngological examinations it was found that gustatory lacrimation occurs only in patients with complete and incomplete degeneration of the nerve situated most frequently at the ganglion geniculi or in the suprageniculate region. Already in the first stage of paralysis when degeneration of the nerve is found with lack or very marked reduction of lacrimation on the involved side it may be predicted with a high probability that crocodile tears will appear. In treatment of this phenomenon antihistamine and anticholinergic agents may be tried with good effects. In severe cases surgical intervention may be considered with elimination of the pathological reflex by sectioning the chorda tympani or Jaeobsen's nerve depending on the pathway of the reflex.