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Balneotherapy-induced Hemifacial Flushing and Hyperhidrosis: Harlequin Syndrome

Author(s): Erkan Kaya | Selçuk Özdoğan | Ali Hikmet Kayar | Mehmet Zeki Kıralp

Journal: Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi
ISSN 1302-0234

Volume: 55;
Issue: 4;
Start page: 179;
Date: 2009;
Original page

Keywords: Balneotherapy | flushing | harlequin syndrome | hemifacial | hyperhidrosis

Harlequin syndrome is a rare condition characterized by hemifacial flushing and sweating, particularly during exercise and heat. There are sudomotor and vasomotor deficits in the cervical sympathetic chain. The sympathetic deficits are usually restricted to the face. Rarely, autonomic deficits affect the arm or the parasympathetic neurons of the ciliary ganglia. We report a 47-year-old woman who presented with facial flushing and sweating in the right side, which were mainly induced by balneotherapy. We used the starch-iodine test to show left hemifacial anhidrosis and the sympathetic skin response. Turk J Phys Med Rehab 2009;55:179-81.
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