Walsh & Hoyt: Inappropriate Lacrimation

Commonly known as crocodile tears (Bogorad syndrome), the gustolacrimal reflex results from an anomalous lacrimal gland innervation that causes profuse and inappropriate tearing in response to stimulation of the taste buds. Most commonly, crocodile tears develop unilaterally in the eye on the side of a facial palsy. However, crocodile tears should not be confused with the watery eye of an acute facial palsy that is due to excess pooling and impaired drainage of tears from loss of normal orbicularis oculis action (blinking). Before discussing the congenital and acquired gustolacrimal reflexes, we will review some of the afferent pathways responsible for transmission of gustatory stimuli and the adjacent efferent pathways to the salivary glands