Isolated acquired primary gusto-lacrimal reflex from a brainstem glioma.

The gusto-lacrimal reflex, also known as Bogorad syndrome, is an autonomic synkinesia in which patients tear excessively in response to salivary stimuli. It most often results from aberrant reinnervation following acute idiopathic or traumatic facial nerve palsy. In rare cases, it occurs as a primary phenomenon in the setting of a slow-growing lesion that compresses or infiltrates the nerve, such as a vestibular schwannoma or meningioma in the internal auditory canal. We describe a patient with gusto-lacrimal reflex without other evidence of facial nerve dysfunction from a low-grade glioma infiltrating the brainstem and cerebellum.