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Abstract The contracture of the facial muscles and the tendency to mass movements of the face which so often follow Bell's palsy have attracted the attention of neurologists since the earliest times, and a great many theories have been offered to explain these phenomena. Sir William Gowers1 was inclined to ascribe the mass movements to a change in the functional state of the nucleus, and Oppenheim, who evidently held similar views, spoke of "irritation" of the facial nucleus. In 1906 Lipschitz2 offered a more satisfactory theory when he claimed that the mass movements were due to misdirection of regenerating nerve fibers. Spiller3 pointed out in 1919 that the same explanation might be offered for facial contracture. Various writers have attempted to explain the syndrome of crocodile tears and the auriculotemporal syndrome on the basis of misdirection of regenerating nerve fibers, and certain phenomena which follow regeneration of the References 1. Gowers, W.: The Movements of the Eyelids , Med.-Chir. Tr. London 62:429, 1879. 2. Lipschitz, R.: Beiträge zur Lehre von Facialislähmung nebst Bemerkungen zur Frage der Nervenregeneration , Monatschr. f. Psychiat. u. Neurol. 20:84, 1906.Crossref 3. Spiller, W. G.: Contracture Occurring in Partial Recovery from Paralysis of the Facial Nerve and Other Nerves , Arch. Neurol. & Psychiat. 1:564 ( (May) ) 1919. 4. Stopford, J. S. B.: An Explanation of the Two-Stage Recovery of Sensation During Regeneration of a Peripheral Nerve , Brain 49:372, 1926. 5. Ramón y Cajal, S.: Degeneration and Regeneration of the Nervous System , New York, Oxford University Press, 1928. 6. Howe, H. A.; Tower, S. S., and Duel, A. B.: Facial Tic in Relation to Injury of the Facial Nerve: An Experimental Study , Arch. Neurol. & Psychiat. 38:1190 ( (Dec.) ) 1937. 7. Bielschowsky, A.: Lectures on Motor Anomalies of the Eyes: Paralysis of Individual Eye Muscles , Arch. Ophth. 13:33 ( (Jan.) ) 1935. 8. Bender, M.: The Nerve Supply to the Orbicularis Muscle and the Physiology of the Movements of the Upper Eyelid, with Particular Reference to the Pseudo-Graefe Phenomenon , Arch. Ophth. 15:21 ( (Jan.) ) 1936. 9. Head, H.: Studies in Neurology , New York, Oxford University Press, 1920, vol. 1. 10. Boring, E. G.: Cutaneous Sensation After Nerve Division , Quart. J. Exper. Physiol. 10:1, 1916. 11. Trotter, W., and Davies. H. M.: Experimental Studies in the Innervation of the Skin , J. Physiol. 38:134, 1908-1909. 12. Cobb, S.: Cutaneous Sensibility in Cases of Peripheral Nerve Injury: Epicritic and Protopathic Hypothesis of Head Untenable , Arch. Neurol. & Psychiat. 2:505 ( (Nov.) ) 1919. 13. Ford, F. R.: Paroxysmal Lacrimation During Eating as a Sequel of Facial Palsy (Syndrome of Crocodile Tears) , Arch. Neurol. & Psychiat. 29:1279 ( (June) ) 1933.
Archives of Surgery – American Medical Association
Published: Mar 1, 1938
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