Once dry, starch is applied over the painted area, and the patient is presented with a salivary stimulus, such as a sour candy. [statpearls.com]

Frey syndrome typically presents in the first few years of life. In some cases, the flushing may be noted as early as 2 to 4 months after birth. [consultant360.com]

The combination of radical surgery, chemotherapy, and irradiation obscured the "textbook" presentation, leading to initial misdiagnosis. [ncbi.nlm.nih.gov]

This factor is released both in utero and after nerve damage, so could connect the two presentations of gustatory sweating. [jnnp.bmj.com]

• Pain

  Unique was the presence of pain and the absence of gustatory sweating in all cases. The combination of radical surgery, chemotherapy, and irradiation obscured the "textbook" presentation, leading to initial misdiagnosis. [ncbi.nlm.nih.gov]

  There is sometimes pain in the same area, often a burning nature. Between attacks of pain there is sometimes numbness or altered sensations (anesthesia or paresthesia). This is termed “gustatory neuralgia”. [drahmetkoc.com]

  Master every essential pain management injection technique used today with Atlas of Pain Management Injection Techniques, 3rd Edition. With expert tips from leading authority Steven D. [books.google.com]

• Surgical Procedure

  SWEATING and flushing of the skin in the parotid region while eating is frequently seen in patients who have had abscesses or surgical procedures of the parotid gland. This symptom complex is commonly referred to as Frey's syndrome. [jamanetwork.com]

  procedures are associated with a decrease in the clinical symptoms of FS.14‒18 However, there are also several others, which found no evidence of such an association.19,20 Like any other surgical procedure, these procedures have their own share of limitations [medcraveonline.com]

  It is often seen with patients who have undergone endoscopic thoracic sympathectomy, a surgical procedure wherein part of the sympathetic trunk is cut or clamped to treat sweating of the hands or blushing. [drahmetkoc.com]

  Quick Summary: Frey’s Syndrome, also known as Gustatory Sweating Syndrome, is a disorder that occurs due to a facial nerve injury, after a surgical procedure is performed (for various reasons), on the parotid gland The parotid gland is located in the [dovemed.com]

  This damage commonly happens during surgical procedures of the parotid gland. Permanent treatment is available in the form of reconstructive surgery. [ohniww.org]

• Inflammation

  […] nerve 5-paralysis Paratrigeminal syndrome Right auriculotemporal syndrome Right Freys trigeminal nerve syndrome Second division of fifth cranial nerve disorder Third division of fifth cranial nerve disorder Trigeminal nerve compression Trigeminal nerve inflammation [icd9data.com]

  If a parotid gland is damaged or if surgery to a parotid is required (damage can occur due to inflammation, infection, and mumps, and tumors can require surgery), then related nerves may become damaged or may regenerate from such damage in a way that [sweathelp.org]

  […] treatment with intradermal botox injection Desire to avoid the sometimes annoying and possibly socially embarrassing dripping of fluid occurring with meals Contraindications include: Changes to the skin that prevent safe manipulation/injection (infections/inflammation [medicine.uiowa.edu]

  However, antiperspirants can irritate the skin and cause inflammation. They can also enter the eye, which can cause irritation and complications that cause pain and blurry vision. For best results, apply a gel antiperspirant to dry skin at night. [verywellhealth.com]

  […] endocardectomy (removal of plaque from the carotid artery) Mandibular Temporal Joint (MTJ) surgery Diabetes Mellitus Herpes Zoster Central Nervous System (CNS) diseases, such as syringomyelia, Cerebrovascular Accident (CVA) or encephalitis Parotitis (inflammation [myhealth1st.com.au]

• Swelling

  Examination shows no swelling, disconfort, tenderness, lymphadenopathy and cutaneous parotid gland region is normal. It is uncommon in children but it has been reported in the first months of life like an episodic facial flushing without sweating. [lucianoschiazza.it]

  The key to unraveling disorders of the parotid gland is to ask the patient about a history of pain and swelling in the region of the gland and determining the relationship of pain and swelling to meals, as acute onset of pain on swelling with salivation [kenhub.com]

  It was not associated with hyperhidrosis, pruritus, discomfort, lip swelling, wheezing, or dyspnea. The patient had not undergone surgery, nor had he had a personal history of atopy. [anaisdedermatologia.org.br]

  There was no associated lip or tongue swelling or difficulty in breathing. Download figure Open in new tab Download powerpoint The patient was referred for skin prick testing which was performed on an extended panel and was negative. [bjgpopen.org]

  The rash always appeared in the same area without pruritus, swelling, respiratory, or gastrointestinal symptoms. [jaci-inpractice.org]

• Fever

  CRS typically begins with low-grade fever and/or myalgias but can escalate over several days to include high fever (which may exceed 40.5 °C). Many cases of mild CRS are resolve with minimal intervention. [jhoonline.biomedcentral.com]

  Also ask about constitutional symptoms (such as unintentional weight loss, night sweats, and low-grade fevers) as this may be suggestive of a non-benign process. [kenhub.com]

• Overeating

  Auriculotemporal syndrome, also known as Frey's syndrome, consists of the development of facial flushing or sweating over the distribution of the auriculotemporal nerve immediately following eating or drinking. [ncbi.nlm.nih.gov]

  over left external ear canal). [ejo.springeropen.com]

  Once dry, starch is applied over the painted area, and the patient is presented with a salivary stimulus, such as a sour candy. [statpearls.com]

• Food Poisoning

  Other conditions that are initially thought to be food allergies include enzyme deficiencies, food poisoning, and pharmacologic agents in foods. [childrenallergyclinic.wordpress.com]

• Sweating

  Frey syndrome results from synkinetic autonomic reinnervation by transected postganglionic parasympathetic nerve fiber within the parotid gland to the overlying sweat glands of the skin. [jhu.pure.elsevier.com]

  The patients later developed facial sweating during meals. [statpearls.com]

  In adults, a sweat test ( Starch iodine) is performed to assess the severity of sweating. Figure 1. Segmental flushing after ingestion of fruit snacks. [dermatologyadvisor.com]

  Flushing prevalent in females, sweating in males. It can persist for life. Some cases are congenital and probably due to birth trauma. [whonamedit.com]

  As a result of severance and inappropriate regeneration, the parasympathetic nerve fibers may switch course, resulting in “gustatory sweating” or sweating in the anticipation of eating, instead of the normal salivatory response. [drahmetkoc.com]

• Flushing

  Gustatory flushing is an abnormal neurological and vascular response triggered by prandial intake. [consultant360.com]

  This transient, unilateral (occasionally bilateral) facial flushing is known as Frey syndrome or auriculotemporal nerve syndrome. Gustatory flushing is an abnormal neurological and vascular response triggered by prandial intake. [contemporarypediatrics.com]

  Segmental flushing after ingestion of fruit snacks. Frey syndrome has to be differentiated from food allergy, in which case the involvement is nonsegmental and bilateral. [dermatologyadvisor.com]

  Question : I recently saw my doctor because I began to have episodes of facial sweating and flushing that would occur during eating or sometimes after I would wake up from a dream. [ohniww.org]

  It is uncommon in children but it has been reported in the first months of life like an episodic facial flushing without sweating. In children usually resolve spontaneously. [lucianoschiazza.it]

• Hyperhidrosis

  Figure 1: Positive iodine starch test: gustatory hyperhidrosis became visible on the distribution of zigomaticofacial nerves Frey′s syndrome, which is also known as auriculo temporal syndrome or gustatory hyperhidrosis, was first described by a neurologist [ijdvl.com]

  Maloney provides treatment for: Axillary (underarm) hyperhidrosis Palmar (hand) hyperhidrosis Plantar (foot) hyperhidrosis Craniofacial hyperhidrosis More information about hyperhidrosis can be found at www.sweathelp.org, the website of the International [dramandamaloney.com]

  Frey syndrome should also be suspected if there is a history of instrumentation during delivery.[3] Hyperhidrosis. [statpearls.com]

  […] axillary hyperhidrosis; Botox for palmar/plantar hyperhidrosis; Botox for other hyperhidrosis; Systemic therapies for hyperhidrosis; Procedural approaches; Endoscopic thoracic sympathectomy; Emerging and investigative treatments; Resources for patients [books.google.com]

• Erythema

  The erythema typically appears in the distribution of the auriculotemporal nerve, which carries sensory input from both skin and sympathetic fibers enervating salivary glands and blood vessels. [contemporarypediatrics.com]

  Because of this, any gustatory stimulus produces erythema and sweating instead of salivation. [dermatologyadvisor.com]

  Clinial features- Sweating Erythema Redness Investigations- Starch iodine test Treatment- Aluminium chloride- antiperspirant Denervation by tympanic neuorectomy Inject Botulinum toxin into affected skin (latest treatment) Exam Important It is gustatory [medicoapps.org]

  Auriculotemporal syndrome (AS) is an uncommon disorder that may present with facial erythema with chewing food. We report a patient referred to an allergist to rule out allergy as a reason for food-associated bilateral facial flushing. [ncbi.nlm.nih.gov]

• Abnormal Sweating

  The Minor starch-iodine test was performed, revealing areas of abnormal sweating (figure 1). [n.neurology.org]

  The subsequent regeneration or nerve sprouting leads to abnormal sweating and salivating. It can also include discharge from the nose when smelling certain food. [drahmetkoc.com]

  Abstract Frey syndrome is a disease characterized by abnormal sweating, facial redness, and rare pain by stimulation of taste sense on the limited area dominated by the auriculotemporal nerve and great auricular nerve. [koreascience.or.kr]

  The subsequent regeneration or nerve sprouting leads to abnormal sweating and salivation. It can also include discharge from the nose when smelling certain food. [en.wikipedia.org]

• Gustatory Sweating

  Otolaryngologic clinics of North America. 2016 Apr; [PubMed PMID: 26902982] [30] Myers EN,Conley J, Gustatory sweating after radical neck dissection. [statpearls.com]

  Unique was the presence of pain and the absence of gustatory sweating in all cases. The combination of radical surgery, chemotherapy, and irradiation obscured the "textbook" presentation, leading to initial misdiagnosis. [ncbi.nlm.nih.gov]

  This factor is released both in utero and after nerve damage, so could connect the two presentations of gustatory sweating. [jnnp.bmj.com]

  Treatment of gustatory sweating and flushing. Acta Otolaryngol 1958;49:132. [ Links ] 5. Dey DL. A variant of auriculotemporal syndrome. Aust N Z J Surg 1953;22:310-311. [ Links ] 6. Haxton HA. Gustatory sweating. Brain 1948;71:16-25. [ Links ] 7. [scielo.br]

• Burning Sensation

  A 38-year-old female patient presented with episodic flushing, burning sensation, and sweating on her right cheek after eating especially spicy and sour food. [ijdvl.com]

  They include: Flushing, warmth, and excessive sweating (localised hyperhidrosis) of ipsilateral facial skin [11] A burning sensation, itching, or pain in the distribution of the auriculotemporal nerve [1]. [dermnetnz.org]

  Between the painful bouts or attacks, the patient can experience a temporary form of numbness or altered sensations like burning in the affected area (paresthesia sensation often as a result of “gustatory neuralgia”). [icliniq.com]

• Headache

  Headache Classification Subcommittee of the International Headache Society: The International Classification of Headaches Disorders, edn 2. Cephalalgia 2004, 24 ( suppl 1 ):1–150. [link.springer.com]

  The auriculotemporal nerve has also recently been implicated in development or perpetuation of migraine headaches. The auriculotemporal nerve arises as two roots from the posterior division of the mandibular nerve. [diki.pl]

  Clinically, branches of the ATN have been implicated as an etiology of some migraine headaches potentially via compression by the superficial temporal artery ( 1 ) and Frey’s syndrome is a known postoperative complication of parotidectomy ( 2 ). [gs.amegroups.com]

  Gustatory sweating can also occur for no known reason (idiopathic) or related to another medical condition ("secondary hyperhidrosis" due to conditions such as diabetes, cluster headaches, Parkinson's, and facial herpes zoster or shingles). [sweathelp.org]

  These include: Chorda tympani injury Cluster headache Diabetic neuropathy Encephalitis Facial herpes zoster (shingles) Syringomyelia Tumor in the cervical sympathetic trunk Diagnosis Diagnostic testing for Frey syndrome can be done using a few different [verywellhealth.com]

• Paresis

  […] sweating for ~ 12 months First injection can last much longer (11-27 months) Describe potential complications Bleeding, infection, reaction to local anesthesia Specific: pain related to injection, indiscriminate injection into facial muscles can result is paresis [medicine.uiowa.edu]

  One patient had transient facial paresis following BT treatment on day 3. [scielo.br]

  Clinical improvement may have a sustained duration of more than 12 months.[26,27,28] The major theoretical adverse effect of the therapy is paresis of the facial nerve branches, but this complication is infrequent if the injections are made posterior [jcadonline.com]

• Paresthesia

  Between attacks of pain there is sometimes numbness or altered sensations (anesthesia or paresthesia). This is termed “gustatory neuralgia”. [drahmetkoc.com]

  Between attacks of pain there may be numbness or other altered sensations (anesthesia or paresthesia). This is sometimes termed "gustatory neuralgia". [en.wikipedia.org]

  Between the painful bouts or attacks, the patient can experience a temporary form of numbness or altered sensations like burning in the affected area (paresthesia sensation often as a result of “gustatory neuralgia”). [icliniq.com]

4 Bilateral forms appear to be largely idiopathic, but a familial bilateral syndrome has already been described.5 The outcome is overall favorable in unilateral cases, with regression in around 57% of cases, at a median age of 27 months.3 No further workup [anaisdedermatologia.org.br]

Completeness of reporting—analysis Completeness of reporting was judged for each included case using the following three components [6]: (1) detailed description of history, symptoms, and findings; (2) information on diagnostic workup, and (3) management [link.springer.com]

Head [PubMed PMID: 21472880] [49] LAAGE-HELLMAN JE, Treatment of gustatory sweating and flushing. Acta oto-laryngologica. 1958 Mar-Apr; [PubMed PMID: 13532654] [50] Drobik C,Laskawi R, Frey's syndrome: treatment with botulinum toxin. [statpearls.com]

There is no definitive /curative treatment. Explain the different treatment options. The treatment is only supportive. All the treatment options have been used with variable success rates. [dermatologyadvisor.com]

One patient had transient facial paresis following BT treatment on day 3. [scielo.br]

Treatments Treatments include: injection of botulinum toxin type A [1] surgical transection of the nerve fibers application of an ointment containing an anticholinergic drug such as scopolamine Eponym It is named for Lucja Frey-Gottesman.[2][3] References [bionity.com]

Clinial features- Sweating Erythema Redness Investigations- Starch iodine test Treatment- Aluminium chloride- antiperspirant Denervation by tympanic neuorectomy Inject Botulinum toxin into affected skin (latest treatment) Exam Important It is gustatory [medicoapps.org]

[…] the discomfort it causes, and the tolerance level of an individual Please find comprehensive information on Frey's Syndrome regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis [dovemed.com]

Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology Histopathology History and Physical Evaluation Treatment / Management Differential Diagnosis Treatment Planning Toxicity and Adverse Effect Management Prognosis [pubmed.ncbi.nlm.nih.gov]

Prognosis is generally good in otherwise uncomplicated cases without any systemic involvement; however, some severe cases may require several surgical interventions as early as from birth. [ajnr.org]

As the method of parotidectomy (4) and prognosis (33) are influenced by benign and malignant tumors, diagnosis of parotid gland lesions prior to parotidectomy is important. [spandidos-publications.com]

[…] contraindicated in patients with motor neuron disease, myasthenia gravis, Eaton-Lambert syndrome, neuropathies, psychological instability, history of an allergic reaction to the toxin or albumin, pregnancy, and infection at the affected skin site.[84] Prognosis [statpearls.com]

Etiology In infants, trauma to the auriculotemporal nerve during forceps-assisted delivery has been implicated in 50% of cases. [dermatologyadvisor.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

The basic etiology of the syndrome is unknown. Certain physiologic considerations are discussed. The condition is benign, nonprogressive and one in which surgical division of the auriculotemporal nerve should be curative. [pediatrics.aappublications.org]

Lucja Frey, who was the first individual to not only describe the symptoms, but also elucidate the correct underlying neuroanatomy of the condition in 1923.[4] Etiology. [jcadonline.com]

The discussion covers the phenotype spectrum, epidemiology, mode of inheritance, pathogenesis, and clinical profile of each condition, all of which is accompanied by a wealth of illustrations. [books.google.com]

Neurology and Neurosurgery Czech and Slovak Ophthalmology Czech and Slovak Psychiatry Czech Geriatric Review Czech Gynaecology Czech Rheumatology Czech Dental Journal Czech Urology Czech-Slovak Dermatology Czecho-Slovak Pathology Czech-Slovak Pediatrics Epidemiology [prolekare.cz]

Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology Histopathology History and Physical Evaluation Treatment / Management Differential Diagnosis Treatment Planning Toxicity and Adverse Effect Management Prognosis [pubmed.ncbi.nlm.nih.gov]

Epidemiology[edit] 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). [en.wikipedia.org]

Molecular medicine reports. 2012 Apr; [PubMed PMID: 22266670] [18] Hohman MH,Bhama PK,Hadlock TA, Epidemiology of iatrogenic facial nerve injury: a decade of experience. [statpearls.com]

The pathophysiology of the syndrome, with particular reference to pain, and possible treatment modalities are discussed. [ncbi.nlm.nih.gov]

It is the purpose of this paper to describe the anatomy and pathophysiology involved and the historical evolution of therapy in order to demonstrate the efficacy of a middle ear surgical procedure which eliminates the distressing symptoms of Frey's syndrome [jamanetwork.com]

Andre Thomas theorized that the pathophysiology of the disease involved aberrant nerve regeneration. Five years later, Dr. [pubmed.ncbi.nlm.nih.gov]

The correct pathophysiology was elucidated by the French pediatric neurologist André-Thomas (1867-1963) 8 who formulated his aberrant regeneration theory, which was published in 1927 6. Curiously Dr. [radiopaedia.org]

Some of the current methods to prevent and treat symptomatic Frey syndrome are reviewed. [jhu.pure.elsevier.com]

If the gustatory stimulus causes activation of the sweat glands, the starch will become moist and turn blue/brown in the presence of iodine.[29] Treatment / Management Preventative Techniques The main method of preventing Frey syndrome from developing [statpearls.com]

Minimally invasive technique with reconstruction remains the gold standard for preventing and treating Frey’s Syndrome. Key Points: Frey’s Syndrome is a rare, yet preventable, surgical complication of traditional parotid surgery. [ohniww.org]

Sternocleidomastoid muscle flap preventing Frey syndrome following parotidectomy. World J Surg. 2004; 28: 361-364 Curry J. King N. Reiter D. et al. Meta-analysis of surgical techniques for preventing parotidectomy sequelae. [oto.theclinics.com]

Surgical methods for the prevention of Frey syndrome Prevention of Frey syndrome has been guided by the alteration of surgical techniques or the addition of procedures focused on preventing synkinesis. [entokey.com]