One sided facial flushing

Harlequin syndrome is a rare autonomic disorder characterized by unilateral facial flushing and sweating with contralateral anhidrosis induced by exercise, heat, and emotion. It is usually idiopathic but could be the first manifestation of several serious underlying medical conditions. Medical or surgical treatments are not required for idiopathic Harlequin syndrome, but social and psychological factors may indicate sympathectomy or botulinum toxin injection. In this article, we report a case of idiopathic Harlequin syndrome and review the literature. Harlequin syndrome is a rare autonomic disorder characterized by unilateral facial flushing and sweating with contralateral anhidrosis induced by exercise, heat, and emotion [ 1 ]. A year-old female presented with a 6-month history of right side hemifacial flushing and sweating during exertion.
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01.09.2020
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Harlequin syndrome

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Harlequin syndrome: the sudden onset of unilateral flushing and sweating

Flushed skin is often a visual sign of embarrassment, anxiety, or being too hot. However, frequent flushing can sometimes indicate an underlying medical condition. Flushed skin occurs when the hundreds of tiny blood vessels just beneath the skin dilate, or widen. When these blood vessels expand, they rapidly fill with more blood, which can make the skin appear red or pink. This effect is more noticeable in regions of the body where the blood vessels are closest to the skin, such as the cheeks and chest. Flushed skin may also feel hot to the touch or cause a slight burning sensation. Flushed skin is usually harmless and short-lived, but it is important to be aware of any other symptoms that may accompany flushing.
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What can cause flushed skin?

Facial flushing and sweating were investigated in five patients who complained of the sudden onset of unilateral facial flushing in hot weather or when exercising vigorously. One patient probably suffered a brainstem infarct at the time that the unilateral flush was first noticed, and was left with a subtle Horner's syndrome on the side opposite to the flush. The other four had no other neurological symptoms and no ocular signs of Horner's syndrome. Thermal and emotional flushing and sweating were found to be impaired on the non-flushing side of the forehead in all five patients whereas gustatory sweating and flushing were increased on that side in four of the five patients, a combination of signs indicating a deficit of the second sympathetic neuron at the level of the third thoracic segment.
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Harlequin syndrome is a condition characterized by asymmetric sweating and flushing on the upper thoracic region of the chest, neck and face. Harlequin syndrome is considered an injury to the autonomic nervous system ANS. The ANS controls some of the body's natural processes such as sweating , skin flushing and pupil response to stimuli. It is an autonomic disorder that may occur at any age.
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