Geniculate Ganglion Facial Palsy

EVER since Ramsay Hunt's (1907)²description of the syndrome of facial palsy, herpetic rash in and around the ear on the same side often accompanied by a constitutional disturbance and sometimes by deafness and giddiness, there has been a tendency to think of a lesion of the nerve trunk at or near the geniculate ganglion only when the Ramsay Hunt syndrome is present. For some years now, however, I have been aware of a group of cases of peripheral facial palsy in which the onset of the paralysis is unaccompanied by any herpetic vesicles around the pinna or by any constitutional disturbance or eighth nerve disorder, but in which there is loss of lachrymal secretion on the paralyzed side, Cawthorne ( 1963).¹Before I included a test of lachrymation as part of the routine examination of eighth nerve function in a case of facial palsy, I used to regard