International Journal of Research and Review Vol. 9; Issue: 2; February 2022 Website: www.ijrrjournal.com Review Article E-ISSN: 2349-9788; P-ISSN: 2454-2237 International Journal of Research and Review (ijrrjournal.com) 432 Vol. 9; Issue: 2; February 2022 The Crocodile Tear Syndrome Hani Yousuf Naik 1 , Mahima Goel 2 , Nida Baloch 3 , Karan Thakkar 4 , Suhani Sharma 5 , Nikita Saha 6 1 Oral and Maxillofacial Surgeon – MDS, I.T.S Dental College and Research Centre, Greater Noida, Delhi NCR 2 Professor – Department of Oral and Maxillofacial Surgery, Pacific Dental College and Research Centre, Udaipur, Rajasthan 3,4 Dental Surgeon – BDS, Pacific Dental College and Research Centre, Udaipur, Rajasthan 5,6 Intern – BDS, Pacific Dental College and Research Centre, Udaipur, Rajasthan Corresponding Author: Hani Yousuf Naik DOI: https://doi.org/10.52403/ijrr.20220255 ABSTRACT The Gusto-lacrimal reflex (The syndrome of Unilateral Lacrimation) associated with eating or drinking was first described by Oppenheim in 1913 and further elaborated by Bogarad in 1928- who called it the SYNDROME OF “CROCODILE TEARS.” The notion that the crocodile, a ferocious predator, will weep over a man’s head after it has devoured the body and then eat up the head too was the theme of one of the many scientific anecdotes of Pliny the Elder. Keywords: Intermediate nerve of Wrisberg, Misdrection of regenerating nerve fibers. INTRODUCTION According to Chorobski, [1] the syndrome of unilateral lacrimation associated with eating or drinking was first described by Oppenheim in 1913 and then described in brief by Bogarad in 1928 who named it as the Syndrome of Crocodile Tears. The case reported by Bogarad was that of a young woman who had a chief complaint of tearing from one eye during eating. This complaint followed the recovery from facial paralysis of the same side. An additional 4 cases were reported by Ford [2] in 1933. All followed facial paralysis. In addition to facial paralysis, one of the patients had congenital syphilis. Axelson and Laage- Hellman called it the “Gusto-Lachrymal Reflex.” They reviewed 67 reported cases upto 1962 and added 16 more. By 1967, 92 cases had been reported in the literature. In 1968, Regenbogen and Stein [4] reported a case who had the syndrome associated with Duane’s Syndrome. The Duane’s Syndrome or Turk-Stilling- Duane’s Syndrome is characterized by esotropia in the primary position, complete abolition of abduction, restriction in adduction, marked retraction of the eye on attempted adduction, narrowing of the palpebral fissure when adduction is attempted and a slight widening of the palpebral fissure when abduction is attempted. It is essentially congenital paralysis of the abducent nerve. In 1970, Spiers [5] reported a case of bilateral crocodile tear syndrome associated with unilateral facial paralysis. ETIOPATHOGENESIS – Ford [3] stated the syndrome of crocodile tears did not occur with the common Bell’s palsy. Chorobski [1] was not in agreement with this opinion. He, thereby, refuted this as he observed a fairly high incidence (8 out of 18 cases) that occurred following recovery from Bell’s Palsy. Boyer and Gardner [6] reported two cases in which the previous facial paralysis did not occur, but developed a as late sequel to sectioning of the greater superficial petrosal