Harlequin Syndrome: Causes, Symptoms and Treatment

He Arlequin syndrome Is a condition characterized by asymmetric sweating and redness in the upper thoracic region of the chest, face and neck. Symptoms (sweating and redness) therefore occur only on one part of the face, chest or neck.

It was first described by Lance and Drummond in 1988. They named it for the character of the theatrical genre Comedy of art .

Arlequin syndrome

Although you still need research to know its causes and cure, it appears that it is caused by an injury in the Sympathetic nervous system . It has also been suggested that it may be the result of a Unilateral endoscopic sympathectomy (ETS) or endoscopic sympathetic block (ESB).


The possible cause of harlequin syndrome is an injury to the Preganglionic sympathetic fibers Or cervical postganglionic and parasympathetic neurons of the Ciliary ganglion .

Research has also led to the belief that torsion of the thoracic spine can cause blockage of the anterior radicular artery, leading to the syndrome. The sympathetic deficit on the denervated side would cause redness on the opposite side.

People suffering from tumors or Strokes (Strokes) may also suffer the symptoms of this syndrome. In some cases, sweating or redness will begin without apparent cause and in other cases will appear for exercise, heat or feel some emotion.


The hallmarks are sweating and redness in the face and neck after exposure to heat, physical exertion or emotional factors.


Harlequin syndrome is not considered a threat to life and because in some people it is not debilitating, it does not involve treatment.

If the damaged nerve is discovered, the treatment can be carried out, the repair being performed surgically. This procedure uses local anesthesia and has been shown to decrease the severity of the syndrome.

Like any other medical condition, patients must maintain open communication with their physicians.


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