Treatment of Frey's syndrome (gustatory sweating) and 'crocodile tears' (gustatory epiphora) with purified botulinum toxin.

PURPOSE: To determine whether purified botulinum toxin might be as effective in the treatment of "crocodile tears" (gustatory epiphora) as it has been in the treatment of other hypersecretion syndromes such as Frey's syndrome (gustatory sweating).

METHODS

One patient with Frey's syndrome (gustatory sweating) was successfully treated with botulinum toxin. After this, two patients with chronic symptomatic crocodile tears (related to previous facial palsy) were treated with botulinum toxin injections into and around the lacrimal gland.

RESULTS

Both patients reported remarkable relief from symptoms and were observed to have no tearing while eating.

CONCLUSIONS

Purified botulinum toxin appears to be an effective treatment for crocodile tears.