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Article
March 1938

PHENOMENA DUE TO MISDIRECTION OF REGENERATING FIBERS OF CRANIAL, SPINAL AND AUTONOMIC NERVESCLINICAL OBSERVATIONS

Author Affiliations

BALTIMORE
From the Neurological Clinic and the Department of Surgery, Johns Hopkins Hospital and School of Medicine.

Arch Surg. 1938;36(3):480-496. doi:10.1001/archsurg.1938.01190210109006
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

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