Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Neurosurgery. 2011 Jul;69(1):E257-9. doi: 10.1227/NEU.0b013e3182186829.
Harlequin syndrome is a rare neurological condition involving various degrees of unilateral hyperhidrosis and erythema of the head and neck. We present a clinical presentation and description of curative therapy in a patient with a sudden onset of Harlequin syndrome following a thoracotomy.
A 42-year-old female with a history of mastectomy for right-sided breast cancer subsequently had a left partial pneumonectomy for a metastasis. Postoperatively, she had onset of contralateral neck and facial flushing and sweating. Flushing was triggered by emotion and exercise, but also occurred spontaneously at random intervals. Magnetic resonance imaging of the brain, cervical spine, and thoracic spine were negative for pathology. Because of the patient's surgical history and negative workup, she was given a diagnosis of Harlequin syndrome. Surgical intervention consisted of a partial right T3 costotransversectomy with T2 sympathectomy. Postoperatively, the patient's symptoms of Harlequin syndrome resolved. The procedure was complicated by T1 radicular pain, which responded well to Gabapentin.
The diagnosis of Harlequin syndrome is relatively new, and the majority of the scientific literature is concerned with descriptive case presentations. We present a surgical technique for the treatment of Harlequin syndrome.
“小丑脸”综合征是一种罕见的神经系统疾病，涉及头颈部不同程度的单侧多汗和红斑。我们报告了 1 例患者在胸腔手术后突发“小丑脸”综合征的临床表现和治疗方法。
患者为 42 岁女性，因右侧乳腺癌接受乳房切除术，随后因转移行左侧部分肺切除术。术后，她出现对侧颈部和面部潮红和出汗。潮红由情绪和运动触发，但也会随机间歇性自发发生。脑部、颈部和胸椎的磁共振成像均未发现病理。鉴于患者的手术史和阴性检查结果，诊断为“小丑脸”综合征。手术干预包括部分右侧 T3 肋横突切除术和 T2 交感神经切除术。术后，患者的“小丑脸”综合征症状得到缓解。手术过程中出现 T1 神经根痛，加巴喷丁治疗效果良好。
“小丑脸”综合征的诊断相对较新，大多数科学文献都关注描述性病例报告。我们介绍了一种治疗“小丑脸”综合征的手术技术。
