Frey's syndrome

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(Redirected from
Gustatory hyperhidrosis
)
Frey's syndrome
Other namesAuriculotemporal syndrome, Baillarger's syndrome, Dupuy’s syndrome, Frey-Baillarger syndrome
Starch-iodine test
Frequency30–50% (after parotidectomy)

Frey's syndrome (also known as Baillarger's syndrome, Dupuy's syndrome, auriculotemporal syndrome,

parotid glands responsible for making saliva, and from damage to the auriculotemporal nerve often from surgery.[1][2]

The symptoms of Frey's syndrome are redness and sweating on the cheek area adjacent to the ear (see

salivation.[3] Observing sweating in the region after eating a lemon wedge may be diagnostic.[2]

Signs and symptoms

Signs and symptoms include

gustatory stimuli. There is sometimes pain in the same area, often burning in nature. Between attacks of pain there may be numbness or other altered sensations (anesthesia or paresthesia
). This is sometimes termed "gustatory neuralgia".

Causes

Frey's syndrome often results as a complication of surgeries of or near the

sympathetic fibers to the sweat glands of the scalp. As a result of severance and inappropriate regeneration, the parasympathetic nerve fibers may switch course to a sympathetic response, resulting in "gustatory sweating" or sweating in the anticipation of eating, instead of the normal salivary response.[2]
It is often seen with patients who have undergone
salivation. It can also include discharge from the nose
when smelling certain food.

Rarely, Frey's syndrome can result from causes other than surgery, including accidental trauma, local infections, sympathetic dysfunction and pathologic lesions within the parotid gland.[4] An example of such rare trauma or localized infection can be seen in situations where a hair follicle has become ingrown, and is causing trauma or localized infection near or over one of the branches of the auriculotemporal nerve.

Diagnosis

Diagnosis is made based on clinical signs and symptoms and a

starch-iodine test, also known as the Minor test. The affected area of the face is painted with iodine which is allowed to dry, then dry corn starch is applied to the face. The starch turns blue on exposure to iodine in the presence of sweat.[5]

Treatments

Cochrane reviews of interventions to either prevent[7] or treat[8]
Frey's syndrome have found little or no evidence to support their effectiveness or safety, and conclude that further clinical trials are needed.

Epidemiology

The condition is rare, although the exact incidence is unknown.[9]

The disorder most often occurs as a complication of the surgical removal of a parotid gland (parotidectomy). The percentage of individuals who develop Frey syndrome after a parotidectomy is controversial and reported estimates range from 30 to 50 percent. In follow-up examinations, approximately 15 percent of affected individuals rated their symptoms as severe. Frey syndrome affects males and females in equal numbers.

History

It is named after Łucja Frey-Gottesman.[10] The disorder was first reported in medical literature by Baillarger in 1853. A neurologist from Poland, Dr. Lucja Frey, provided a detailed assessment of the disorder and coined the term "auriculotemporal syndrome" in 1923.[11]

References

  1. ^ a b "Frey's syndrome". Genetic and Rare Diseases Information Center (GARD). National Institutes of Health, U.S. Department of Health & Human Services. 2011. Retrieved 17 December 2012.
  2. ^
    PMID 16822997
    .
  3. ^ "Frey's Syndrome Treatment: What You Need to Know". Parotid Tumor Surgery | Salivary Gland Surgery Los Angeles CA. Retrieved 2021-02-07.
  4. PMID 21496996
    .
  5. PMID 24353866
    .
  6. ^ "Onabotulinumtoxina (Injection Route, Intradermal Route, Intramuscular Route)". Mayo Clinic. 2011. Retrieved 18 December 2012.
  7. PMID 31578708
    .
  8. PMID 25781421
    .
  9. ^ "Frey Syndrome". NORD (National Organization for Rare Disorders). Retrieved 2019-01-26.
  10. Who Named It?
  11. ^ Frey L (1923). "Le syndrome du nerf auriculo-temporal" [Atriotemporal nerve syndrome]. Rev. Neurol. (in French). 2: 97–104.

External links

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