I. Translation: Bogorad’s syndrome
II. Aliases.
①crocodile tear syndrome;
②Crocodile lacrimal syndrome;
③ paroxysmal lacrimal syndrome;
④Paroxysmal lacrimal overflow syndrome;
⑤ appetitive lacrimation syndrome;
⑥Eating lacrimation syndrome;
(vii) Tear taste reflex phenomenon.
The syndrome was described by Oppenheim in 1908, and Bogorad officially named it as crocodile tear syndrome in 1 928. The main characteristic is tearing when eating, and it occurs several weeks to years after facial nerve paralysis. It can be transient or last for decades.
Etiology: skull base fracture, facial nerve or superficial nerve resection and facial nerve paralysis sequelae and other factors, resulting in the wrong regeneration of nerve fibers leading to the salivary glands, nerve fibers leading to the lacrimal glands or tear secretion, stimulated by some factors and cause the disease. Food stimulation not only increases the secretion of salivary glands, but also increases the lacrimal fluid.
V. Ocular features.
1. When eating as well as chewing food or even trying to eat, it causes lacrimation on the paralyzed side, and the degree of lacrimation varies from tearing the eyelids to tearing all over the face, with varying degrees of severity, which is very painful.
2. Lid ectropion and incomplete lid closure are also seen.
VI. Systemic features.
1, peripheral facial palsy, sometimes combined with facial nerve spasm and paralysis.
2. Excessive salivary secretion.
Differential diagnosis.
①Simple tearing phenomenon in facial palsy.
②Auriculotemporal syndrome.
Treatment: Symptomatic treatment with drugs, such as anti-adrenaline drug 5% guanethidine drops, oral anti-acetylcholine drug probenecid, etc.; also can do local anhydrous ethanol closure of the pterygopalatine ganglion. Before closure, lidocaine can be used to anesthetize the nasal mucosa near the pterygopalatine nerve, and if effective, ethanol closure can be performed again. Most of the patients with this symptom can be relieved or even cured by themselves, and three cases in this group were cured without special treatment. For those who do not recover and whose symptoms are more severe and seriously affect their lives. The affected bulbar nerve can be cut off, or part of the lacrimal gland can be cut off, and the pterygopalatine node can also be closed and other treatments are feasible.