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January 1986, Vol 43, No. 1 >
Article | January 1986

Trigeminal-Palatal Synkinesis

Beum S. Kim, MD; Charles G. Maitland, MD; Peter S. Roland, MD
[+] Author Affiliations

Accepted for publication Oct 24, 1984.

Reprint requests to Tallahassee Neurological Clinic, 1401 Centerville Rd, Tallahassee, FL 32308 (Dr Maitland).


Arch Neurol. 1986;43(1):88-90. doi:10.1001/archneur.1986.00520010082028
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Comments

• A patient developed synkinetic movements of facial musculature and "crocodile tears" following the removal of a large acoustic neurinoma. A reflex palatal movement resulted from tactile stimulation of the lower part of the face as well. Analysis of the palatal movement suggested action of the tensor veli palatini muscle, acting in isolation. We believe the palatal contraction represents a synkinetic phenomenon involving both sensory and motor nerve fibers within the motor root of the trigeminal nerve.

REFERENCES

1 +
Wartenberg R:  Associated movements in the oculomotor and facial muscles . Arch Neurol Psychiatry 1946;;55:439-488.
2 +
Crumley RL:  Mechanisms of synkinesis . Laryngoscope 1979;;89:1847-1854.
3 +
Walsh FB:  Third-nerve regeneration . Br J Ophthalmol 1957;;41:577-598.
4 +
Sebag J, Sadun AA:  Aberrant regeneration of the third nerve following orbital trauma . Arch Neurol 1983;;40:762-764.
5 +
Walsh FB, Hoyt WF: Clinical Neuro-ophthalmology , ed 3. Baltimore, Williams & Wilkins Co, 1969;, vol 1, pp 558-562.
6 +
Eckman PB, Kramer RA, Altrocchi PH:  Hemifacial spasm . Arch Neurol 1971;;25:81-87.
7 +
Ehni G, Woltman HW:  Hemifacial spasm: Review of 106 cases . Arch Neurol Psychiatry 1945;;53:205-211.
8 +
Saunders RL, Krout R, Sachs E:  Masticator electromyography in trigeminal neuralgia . Neurology 1971;;21:1221-1225.
9 +
Warwick R, Williams PL (eds): Gray's Anatomy , ed 35. Philadelphia, WB Saunders Co, 1980;, p 1208.
10 +
Wakabayashi T, Tamaki N, Sato H, et al:  Epidermoid tumor presenting as painful tic convulsif . Surg Neurol 1983;;19:244-246.
11 +
DeJong RN: The Neurologic Examination , ed 3. Hagerstown, Md, Harper & Row Publishers Ine, 1967;, p 215.
12 +
Goor C, Ongerboer De Visser BW:  Jaw and blink reflexes in trigeminal nerve lesions . Neurology 1976;;26:95-97.
13 +
Ongerboer De Visser BW, Goor C:  Electromyographic and reflex study in idiopathic and symptomatic trigeminal neuralgias: Latency of the jaw and blink reflexes . J Neurol Neurosurg Psychiatry 1974;;37:1225-1230.
14 +
Lepore FE, Glaser JS:  Misdirection revisited: A critical appraisal of acquired oculomotor nerve synkinesis . Arch Ophthalmol 1980;;98:2206-2209.
15 +
Sibony PA, Lessell S:  Transient oculomotor synkinesis in temporal arteritis . Arch Neurol 1984;;41:87-88.
16 +
Kim P, Fukushima T:  Observations on synkinesis in patients with hemifacial spasm . J Neurosurg 1984;;60:821-827.
17 +
Nielsen VK, Jannetta PJ:  Pathophysiology of hemifacial spasms: III. Effects of facial nerve decompression . Neurology 1984;;34:891-897.
18 +
Granit R, Leksell L, Skoglund CR:  Fiber interaction in injured or compressed region of nerve . Brain 1944;;67:125-140.
19 +
Granit R, Skoglund CR:  Facilitation, inhibition and depression at the 'artificial synapse' formed by the cut end of a mammalian nerve . J Physiol 1945;;103:435-448.
20 +
Ferguson JH:  Hemifacial spasm and the facial nucleus . Ann Neurol 1978;;4:97-103.
21 +
Ansink JJ:  Physiologic and clinical investigations into four brain-stem reflexes . Neurology 1962;;12:320-328.

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1 +
Wartenberg R:  Associated movements in the oculomotor and facial muscles . Arch Neurol Psychiatry 1946;;55:439-488.
2 +
Crumley RL:  Mechanisms of synkinesis . Laryngoscope 1979;;89:1847-1854.
3 +
Walsh FB:  Third-nerve regeneration . Br J Ophthalmol 1957;;41:577-598.
4 +
Sebag J, Sadun AA:  Aberrant regeneration of the third nerve following orbital trauma . Arch Neurol 1983;;40:762-764.
5 +
Walsh FB, Hoyt WF: Clinical Neuro-ophthalmology , ed 3. Baltimore, Williams & Wilkins Co, 1969;, vol 1, pp 558-562.
6 +
Eckman PB, Kramer RA, Altrocchi PH:  Hemifacial spasm . Arch Neurol 1971;;25:81-87.
7 +
Ehni G, Woltman HW:  Hemifacial spasm: Review of 106 cases . Arch Neurol Psychiatry 1945;;53:205-211.
8 +
Saunders RL, Krout R, Sachs E:  Masticator electromyography in trigeminal neuralgia . Neurology 1971;;21:1221-1225.
9 +
Warwick R, Williams PL (eds): Gray's Anatomy , ed 35. Philadelphia, WB Saunders Co, 1980;, p 1208.
10 +
Wakabayashi T, Tamaki N, Sato H, et al:  Epidermoid tumor presenting as painful tic convulsif . Surg Neurol 1983;;19:244-246.
11 +
DeJong RN: The Neurologic Examination , ed 3. Hagerstown, Md, Harper & Row Publishers Ine, 1967;, p 215.
12 +
Goor C, Ongerboer De Visser BW:  Jaw and blink reflexes in trigeminal nerve lesions . Neurology 1976;;26:95-97.
13 +
Ongerboer De Visser BW, Goor C:  Electromyographic and reflex study in idiopathic and symptomatic trigeminal neuralgias: Latency of the jaw and blink reflexes . J Neurol Neurosurg Psychiatry 1974;;37:1225-1230.
14 +
Lepore FE, Glaser JS:  Misdirection revisited: A critical appraisal of acquired oculomotor nerve synkinesis . Arch Ophthalmol 1980;;98:2206-2209.
15 +
Sibony PA, Lessell S:  Transient oculomotor synkinesis in temporal arteritis . Arch Neurol 1984;;41:87-88.
16 +
Kim P, Fukushima T:  Observations on synkinesis in patients with hemifacial spasm . J Neurosurg 1984;;60:821-827.
17 +
Nielsen VK, Jannetta PJ:  Pathophysiology of hemifacial spasms: III. Effects of facial nerve decompression . Neurology 1984;;34:891-897.
18 +
Granit R, Leksell L, Skoglund CR:  Fiber interaction in injured or compressed region of nerve . Brain 1944;;67:125-140.
19 +
Granit R, Skoglund CR:  Facilitation, inhibition and depression at the 'artificial synapse' formed by the cut end of a mammalian nerve . J Physiol 1945;;103:435-448.
20 +
Ferguson JH:  Hemifacial spasm and the facial nucleus . Ann Neurol 1978;;4:97-103.
21 +
Ansink JJ:  Physiologic and clinical investigations into four brain-stem reflexes . Neurology 1962;;12:320-328.

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