Frey syndrome

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Classification according to ICD-10
G50.8 Frey's disease
ICD-10 online (WHO version 2019)

The term Frey syndrome , also known as auriculotemporal syndrome , gustatory sweating and gustatory hyperhidrosis , is an abnormally pronounced sweating in circumscribed areas of the skin of the face and neck area that occurs during consumption of any food or with gustatory (i.e. taste) Stimuli such as B. candy sucking, tasting, chewing, biting is triggered.

Frey syndrome was named after the Polish neurologist Łucja Frey-Gottesman (1889–1942), who described the disease in 1923. However, there are already earlier descriptions by Duphenix (1757) and von Baillarger (1853) and is therefore sometimes referred to as Frey-Baillarger syndrome .

root cause

The so-called "taste sweating" arises from the fact that vegetative parasympathetic (secretory) nerve impulses, which originate from a nerve branch ( chorda tympani ) of the seventh cranial nerve ( nervus facial ), usually used for saliva secretion , are misdirected. For example, after a trauma, an operation, etc. in the context of re-sprouting, i. H. the regeneration of the damaged nerves, to a new, faulty nerve contact with (sympathetic) nerve fibers, which actually serve the secretion of sweat. Figuratively speaking, the impulses (common to both types of nerve fibers) that are transmitted via the carrier substance acetylcholine have lost their original target organ, the salivary gland, and instead “accidentally” docked on the sweat glands as part of the healing process. In every situation that would normally trigger salivation, sweat secretions occur and you can suddenly see the patient from the outside, "the mouth is watering".

The symptoms are accordingly generally after surgery, after partial or complete removal of salivary gland proportions after a trauma , peripheral facial paresis or inflammation in particular the parotid gland (lat. Parotid gland ) or the submandibular gland (lat. Submandibular gland ). In some case studies, it was observed after the birth and was mostly assessed as the result of a birth trauma, for example by forceps that injure the salivary gland through pressure.

therapy

By means of local injection of botulinum toxin A , the syndrome of gustatory sweating, which is very debilitating for the affected person, can now be effectively treated.

swell

  • L. Frey: Zespół nerwu uszno-skroniowego . 1923.
  • L. Frey: Le syndrome du nerf auriculo-temporal. In: Revue neurologique. Paris 1923, 30 (2), pp. 97-104.
  • M. Duphenix: Observations on the fistules du canal salivaire de Stenson. I. Sur une playe complique à la joue ou le canal salivaire fut déchireé. In: Mémoires de l'Académie royale de chirurgie. 1757, III, pp. 431-439.
  • JGF Baillarger: Mémoire sur l'obliteration du canal du Sténon. In: Gazette médicale de Paris. 1853, 23, pp. 194-197.

Web links

Individual evidence

  1. Alexander Smith, Nico Jonas: Images in Clinical Medicine - Frey's Syndrome New England Journal of Medicine 2020, Volume 382, ​​Issue 15 of April 9, 2020, page 1456, DOI: 10.1056 / NEJMicm1809117