title: [Bilateral "crocodile tears syndrome" associated with Melkersson-Rosenthal syndrome--case report].
abstract: 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.
authors.affiliation: Katedra i Klinika Neurologii, Akademia Medyczna, ul. Przybyszewskiego 49, 60-355 Poznań. michal.owecki@wp.pl
authors.forename: Michał K
authors.initials: MK
authors.lastname: Owecki
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kapelusiak-Pielok
authors.forename: Piotr
authors.initials: P
authors.lastname: Kowal
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kozubski
mesh_terms: D001905:Botulinum Toxins / Q000627:therapeutic use; D006801:Humans; D007765:Lacrimal Apparatus / Q000294:innervation / Q000378:metabolism; D007766:Lacrimal Apparatus Diseases / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008556:Melkersson-Rosenthal Syndrome / Q000150:complications* / Q000188:drug therapy*; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use; D035583:Rare Diseases; D013577:Syndrome
chemical_list: D009465:Neuromuscular Agents; D001905:Botulinum Toxins