Harlequin Syndrome After Thoracic Paravertebral Block

We present a case of Harlequin syndrome without Horner syndrome in a patient with unilateral right-sided facial flushing that started shortly after a left-sided thoracic paravertebral nerve block for a mastectomy. We discuss the interruption of the sympathetic and parasympathetic nervous system and the levels of spinal nerve block associated with a thoracic paravertebral nerve block.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports: Clinical Care Source Type: research

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We describe a case of Harlequin syndrome with co-existing central first-order Horner syndrome in the setting of a large thalamic hemorrhage with intraventricular extension.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
We report a case of idiopathic harlequin syndrome in a 34-year-old man with a 5-month history of unilateral facial flushing and sweating after exercise. Despite the rarity of this syndrome, dermatologists should be aware of this condition in order to diagnose properly and provide multidisciplinary assistance.
Source: Anais Brasileiros de Dermatologia - Category: Dermatology Source Type: research
We report a case of harlequin syndrome associated with Horner syndrome in an 11-year boy who underwent excision of right neck schwannoma. Lessons: Clinicians should consider the point that harlequin syndrome could occur as a first sign of more serious conditions.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Authors: Jeon YJ, Son J, Cho JH Abstract Harlequin syndrome is a rare disorder of the sympathetic nervous system characterized by unilateral facial flushing and sweating. Although its etiology is unknown, this syndrome appears to be a dysfunction of the autonomic nervous system. To the best of our knowledge, thus far, very few reports on perioperative Harlequin syndrome after thoracic surgery have been published in the thoracic surgical literature. Here, we present the case of a 6-year-old patient who developed this unusual syndrome following the resection of a posterior mediastinal mass. PMID: 28382275 [PubMed - in process]
Source: Korean Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Korean J Thorac Cardiovasc Surg Source Type: research
Abstract Harlequin syndrome is a rare autonomic disorder referring to the sudden development of flushing and sweating limited to one side of the face. Like Horner syndrome, associating miosis, ptosis, and anhidrosis, Harlequin syndrome is caused by disruption of the cervical sympathetic pathways. Authors of this report describe the case of a 55-year-old female who presented with both Harlequin sign and Horner syndrome immediately after anterior cervical discectomy (C6-7) with cage fusion and anterior spondylodesis. They discuss the pathophysiology underlying this striking phenomenon and the benign course of this c...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
Conclusion: The strictly LEFT sided facial flushing that occurred with exertion in this patient demonstrates the patient’s loss of sweating on the RIGHT, non-flushed side of the face, suggestive of abnormal sympathetic activation on the RIGHT and consistent with Harlequin syndrome. Although cluster patients typically exhibit unilateral ipsilateral autonomic dysfunction during a cluster attack, ipsilateral sympathetic dysfunction may also occur inter-ictally. While most cases of Harlequin syndrome are benign, care must be taken to rule out a lesion along the sympathetic tract, especially along the postganglionic cervi...
Source: Neurology - Category: Neurology Authors: Tags: Headache: Basic Science and Clinical Presentation/Diagnosis Source Type: research
We present the case of a child in whom the syndrome was associated with Horner's syndrome, epilepsy, mental and psychomotor retardation. PATIENTS AND METHODS: A 9-year-old boy presented with right unilateral hemifacial erythema on effort, with normal colouring and Horner's syndrome on the left side of the face. His medical history revealed generalized myoclonic epilepsy, psychomotor delay and mental retardation. No underlying anomalies were identified. Harlequin phenomenon was diagnosed. DISCUSSION: Despite its stereotypical clinical features, Harlequin phenomenon is a poorly known disease. However...
Source: Annales de Dermatologie et de Cenereologie - Category: Dermatology Authors: Tags: Ann Dermatol Venereol Source Type: research
Abstract The author presents a patient with Harlequin and Horner syndromes as part of an autoimmune autonomic ganglionopathy and suggests implication for work-up and management. In general, Harlequin and Horner syndromes are reported to be caused by either a structural lesion of the sympathetic pathway or, when no structural lesion is found, are presumed to be idiopathic. In this paper, a 76year old man developed a Harlequin and Horner syndromes in the setting of subacute autonomic failure and other systemic features. The patient's symptoms improved with a short course of intravenous methylprednisolone. An autoimm...
Source: Autonomic Neuroscience - Category: Neuroscience Authors: Tags: Auton Neurosci Source Type: research
The author presents a patient with Harlequin's and Horner's syndrome as part of an autoimmune autonomic ganglionopathy and suggests implication for work-up and management. In general, Harlequin's and Horner's syndromes are reported to be caused by either a structural lesion of the sympathetic pathway or, when no structural lesion is found, are presumed to be idiopathic. In this paper, a 76year old man developed a Harlequin's and Horner's syndrome in the setting of subacute autonomic failure and other systemic features.
Source: Autonomic Neuroscience: Basic and Clinical - Category: Neuroscience Authors: Source Type: research
We report a rare case of Harlequin and Horner syndromes attributed to systemic sarcoidosis.
Source: Nature Clinical Practice - Category: Neurology Authors: Tags: All Clinical Neurology, All Medical/Systemic disease, All Neuro-ophthalmology Cases Source Type: research
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