Frey syndrome

Frey Syndrome Frey syndrome, also known as auriculotemporal syndrome, is a rare neurological disorder characterized by sweating and flushing occurring on the cheek area adjacent to the ear. This phenomenon typically occurs during eating or thinking about food, a condition known as gustatory sweating.

Etiology

Frey syndrome is most commonly associated with surgical procedures involving the parotid gland, such as parotidectomy. It can also occur after trauma or infection in the region of the parotid gland. The condition arises due to aberrant regeneration of parasympathetic nerve fibers, which mistakenly connect to sweat glands instead of salivary glands.

Pathophysiology

The pathophysiology of Frey syndrome involves the misdirection of nerve fibers. After damage to the auriculotemporal nerve, which carries parasympathetic fibers to the parotid gland, these fibers can regenerate abnormally. Instead of reconnecting with the salivary glands, they connect with the sweat glands in the skin, leading to sweating and flushing during salivation.

Clinical Presentation

Patients with Frey syndrome typically present with unilateral sweating and flushing of the skin over the cheek, temple, and behind the ear. These symptoms are triggered by eating, thinking about food, or even smelling food. The condition is usually benign but can be socially embarrassing for the affected individuals.

Diagnosis

Diagnosis of Frey syndrome is primarily clinical, based on the characteristic symptoms. The Minor's starch-iodine test can be used to confirm the diagnosis. In this test, iodine is applied to the affected area, followed by starch. When the patient eats or thinks about food, the area of sweating will turn blue-black due to the reaction between iodine and starch.

Management

Management of Frey syndrome can be challenging. Treatment options include:

• Topical Antiperspirants: Aluminum chloride solutions can be applied to reduce sweating.
• Botulinum Toxin Injections: Botulinum toxin can be injected into the affected area to block the nerve signals causing sweating.
• Surgical Interventions: In severe cases, surgical options such as tympanic neurectomy or interpositional grafting may be considered.

Prognosis

The prognosis for Frey syndrome is generally good, as it is a benign condition. However, the symptoms can persist for many years and may require ongoing management.

Epidemiology

Frey syndrome is considered a rare condition, with an incidence that varies depending on the population studied. It is most commonly seen following parotid gland surgery, with estimates suggesting it occurs in 10-50% of such cases.

See Also

• Parotidectomy
• Auriculotemporal nerve
• Gustatory sweating

External Links

• [Link to a reputable medical resource]

NIH genetic and rare disease info

• NIH info on Frey syndrome

Frey syndrome is a rare disease.