Endgames Spot Diagnosis

Unilateral facial flushing precipitated by eating

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1377 (Published 09 March 2016) Cite this as: BMJ 2016;352:i1377
  1. Ella Daniels, foundation year 1 doctor1,
  2. Richard Watchorn, specialty registrar in dermatology2
  1. 1Tunbridge Wells Hospital, Tunbridge Wells TN2 4QJ, UK
  2. 2Royal Devon and Exeter Hospital, Exeter, UK
  1. Correspondence to: E Daniels ella.daniels{at}nhs.net

A healthy 7 year old girl born by forceps delivery presented with a lifelong history of unilateral facial flushing precipitated by eating (fig 1). What diagnosis correlates with these clinical findings?

Answer

Frey’s syndrome. This occurs after injury (during forceps delivery in this case) to auriculotemporal nerve fibres, which regenerate and erroneously stimulate the sweat glands or blood vessels …

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