Isolated Acquired Primary Crocodile Tears

The crocodile sheds tears as a physiologic response to mastication. Humans however, produce tears while eating (the gusto-lacrimal reflex) only after pathologic repair with misdirected recovery in the seventh cranial nerve. Crocodile tears are associated with facial nerve injury either traumatic, idiopathic, or with associated brain stem pathologies. This gusto-lacrimal reflex is seen with signs of facial nerve damage and repair, hypothetically the consequence of misdirection or ephaptic transmission. Isolated acquired gusto-lacrimation without any sign of associated neural motor fiber involvement is virtually unique. We report such a case.