
Harlequin Syndrome with Crossed Sympathetic Deficit of the Face and Arm
Author(s) -
So Young Moon,
DongIn Shin,
Seong-Ho Park,
Ji Soo Kim
Publication year - 2005
Publication title -
journal of korean medical science/journal of korean medical science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.743
H-Index - 66
eISSN - 1598-6357
pISSN - 1011-8934
DOI - 10.3346/jkms.2005.20.2.329
Subject(s) - medicine , hyperhidrosis , valsalva maneuver , pilocarpine , sympathectomy , anesthesia , autonomic nervous system , cardiology , blood pressure , heart rate , epilepsy , psychiatry
Harlequin syndrome is characterized by unilateral hyperhidrosis and flushing, which are predominantly induced by heat or exercise. Usually, the sympathetic deficits confine to the face. Rarely, the autonomic deficits involve the arm or the parasympathetic neurons in the ciliary ganglia. We report a 43-yr-old woman who presented with facial flushing and sweating in the right side, which were mainly induced by exercise. The facial flushing accompanied relative coldness in the right arm. Valsalva maneuver, cold pressure and 0.125% pilocarpine test, and computed tomography of the chest were normal. The crossed sympathetic deficit in the left face and right arm suggested that the lesions were multifocal. The sympathetic impairment in our patient may lie on a spectrum of pre- and postganglionic autonomic dysfunction, which was observed in Holmes-Adie, Ross, and Guillain-Barre syndromé.