Isolated acquired primary gusto-lacrimal reflex from a brainstem glioma

Klein, Ami; Miller, Neil R.

doi:10.1212/01.wnl.0000436062.12890.fb

Cited by 3 publications

(12 citation statements)

References 5 publications

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“…However, this could lead to increased intraocular pressure (IOP) from gas overfill or reverse pupillary block during, as well as after surgery. 3 Here, we present, to our knowledge, the first unusual case of spontaneous malignant glaucoma that developed intraoperatively during DMEK, and to discuss the immediate and postoperative management of this scenario.…”

Section: Descemet Membrane Endothelial Keratoplasty Developing Spontamentioning

confidence: 99%

“…(b) CTS without antecedent facial nerve palsy. 3 Here, we present, to our knowledge, the first unusual case of spontaneous malignant glaucoma that developed intraoperatively during DMEK, and to discuss the immediate and postoperative management of this scenario. 1 Descemet membrane endothelial keratoplasty developing spontaneous 'malignant glaucoma' secondary to gas misdirection Descemet membrane endothelial keratoplasty (DMEK) is increasingly being performed in eyes with corneal decompensation secondary to endothelial disease.…”

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confidence: 99%

“…3 Boyer and Gardner 1 described two cases who developed CTS after resection of the greater superficial petrosal nerve for intractable headaches. This is rare in literature and to the best of our knowledge, only a handful of other cases have demonstrated CTS occurring without facial palsy but have all occurred months after the initial insult.…”

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confidence: 99%

“…One case by Klein and Miller 3 reported that CTS was the only evidence of facial nerve dysfunction as a result of a slow-growing meningioma but resulted from selective damage to the superior salivatory nucleus, as neuroimaging indicated the lesion involving pontine tegmentum. 3 Boyer and Gardner 1 described two cases who developed CTS after resection of the greater superficial petrosal nerve for intractable headaches. They suggested that this was due to regenerated autonomic nerve fibres and found that sectioning of the glossopharyngeal nerve relieved CTS hypothesizing that this nerve was also crucial to the development of the condition.…”

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Acute crocodile tear syndrome without antecedent facial nerve palsy

Hardy

2018

Clinical Exper Ophthalmology

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Section: Descemet Membrane Endothelial Keratoplasty Developing Spontamentioning

confidence: 99%

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Acute crocodile tear syndrome without antecedent facial nerve palsy

Hardy

2018

Clinical Exper Ophthalmology

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“…Previous reports most commonly associate this condition with recovery following facial nerve trauma or palsy [1]. Sporadic cases have been reported in the context of slow-growing tumours affecting the facial nerve, directly or indirectly [2]. Congenitally, it is been associated with Duane's retraction syndrome [2].…”

Section: Introductionmentioning

confidence: 99%

Crocodile tear syndrome post microvascular decompression of the trigeminal nerve: a case report and literature review

Abul¹

2021

Preprint

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Background Crocodile tear syndrome (CTS) is a condition characterised by excessive tear secretion in response to eating, drinking, or smelling foods. Traditionally, acquired cases are most commonly reported following facial nerve trauma or paralysis, or in slow-growing facial nerve tumours. More recently, it has been reported following vestibular Schwannoma surgery. We report the first case of crocodile tear syndrome following microvascular decompression of the trigeminal nerve. Case presentation A 61-year-old lady presented with excessive lacrimation and clear rhinorrhoea one month post-operatively from a re-do trigeminal microvascular decompression surgery. The patient experienced similar symptoms following her initial surgery two years prior, which had resolved spontaneously. CT and MRI head, and comprehensive clinical examination showed no evidence of CSF rhinorrhoea or cause of her symptoms. An ENT opinion was sought, and the patient was diagnosed with post-operative crocodile tear syndrome.Literature review revealed no reported cases of CTS following microvascular decompression of the trigeminal nerve. Surgical technique and relevant imaging were reviewed for any possible explanation for the condition. Considering the accepted pathogenesis of CTS, we discuss the aetio-pathogenesis for the development of the condition following this procedure. Conclusions We conclude CTS should be considered in patients presenting with rhinorrhoea following microvascular decompression of the trigeminal nerve. In patients presenting with post-operative rhinorrhoea after MVD, after excluding CSF leak, CTS should be considered as a potential differential diagnosis. Treatment for CTS in this context may pose a challenge. The patient has undergone botulinum toxin injection of the lacrimal gland and will need long term follow up. This is the first documented case of CTS post microvascular decompression of the trigeminal nerve.

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Crocodile Tear Syndrome Post Microvascular Decompression of the Trigeminal Nerve: A Case Report and Literature Review

2023

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Background: Crocodile Tear Syndrome (CTS) is a condition characterised by excessive tear secretion in response to eating, drinking, or smelling foods. Traditionally, acquired cases are most commonly reported following facial nerve trauma or paralysis, or in slow-growing facial nerve tumours. More recently, it has been reported following vestibular Schwannoma surgery. We report the first case of crocodile tear syndrome following microvascular decompression of the trigeminal nerve. Case Presentation: A 61-year-old lady presented with excessive lacrimation and clear rhinorrhoea one month post-operatively from a re-do trigeminal microvascular decompression (MVD) surgery. The patient experienced similar symptoms following her initial surgery two years prior, which had resolved spontaneously. CT and MRI head, and comprehensive clinical examination showed no evidence of CSF leak from her retromastoid wound site. An ENT opinion was sought, and the patient was diagnosed with post-operative crocodile tear syndrome. Surgical technique and relevant imaging were reviewed for any possible explanation for the condition. We discuss the possible aetio-pathogenesis for the development of the condition following MVD procedure. Conclusion: We conclude that CTS should be considered in patients presenting with CSF rhinorrhoea following MVD of Trigeminal nerve after excluding CSF leak from the middle ear via eustachian tube. Treatment for CTS in this context may pose a challenge. The patient has undergone botulinum toxin injection of the lacrimal gland and will likely need long term follow up. This is the first documented case of CTS post microvascular decompression of the trigeminal nerve.

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Isolated acquired primary gusto-lacrimal reflex from a brainstem glioma

Cited by 3 publications

References 5 publications

Acute crocodile tear syndrome without antecedent facial nerve palsy

Acute crocodile tear syndrome without antecedent facial nerve palsy

Crocodile tear syndrome post microvascular decompression of the trigeminal nerve: a case report and literature review

Crocodile Tear Syndrome Post Microvascular Decompression of the Trigeminal Nerve: A Case Report and Literature Review

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