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September 9, 1939

ABNORMAL MOVEMENTS FOLLOWING INJURY TO THE FACIAL NERVE

JAMA. 1939;113(11):1003-1008. doi:10.1001/jama.1939.02800360017006
Abstract

Abnormal movements of the face following recovery from toxic neuritis of the facial nerve (Bell's palsy) are much more common than is generally supposed. Patients who recover from traumatic lesions to the nerve invariably show abnormal associated movements of the facial musculature and often have annoying tics on the affected side of the face.1 Some patients, after the disappearance of the paralysis, suffer from sweating and excessive lacrimation on the injured side while eating (crocodile tear syndrome2).

Opinions as to the cause of these phenomena have been divergent. One school maintained that the ticlike movements are central in origin and the other that they are peripheral. Unfortunately, the two most assiduous workers in this field, the late Dr. Arthur B. Duel and the late Sir Charles Ballance, while studying facial nerve grafts disagreed as to the origin of the ticlike movements and, on different sides of the ocean,

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