Harlequin syndrome is characterized by unilateral hyperhidrosis and flushing, which are predominantly induced by heat or exercise. Usually, the sympathetic deficits confine to the face. Rarely, the autonomic deficits involve the arm or the parasympathetic neurons in the ciliary ganglia. We report a 43-yr-old woman who presented with facial flushing and sweating in the right side, which were mainly induced by exercise. The facial flushing accompanied relative coldness in the right arm. Valsalva maneuver, cold pressure and 0.125% pilocarpine test, and computed tomography of the chest were normal. The crossed sympathetic deficit in the left face and right arm suggested that the lesions were multifocal. The sympathetic impairment in our patient may lie on a spectrum of pre- and postganglionic autonomic dysfunction, which was observed in Holmes-Adie, Ross, and Guillain-Barre syndrome.
Adult ; Arm/innervation/*physiopathology ; Autonomic Nervous System Diseases/*physiopathology ; Face/innervation/*physiopathology ; Female ; Flushing/*physiopathology ; Humans ; Research Support, Non-U.S. Gov't ; Sweating/*physiology ; Syndrome

OBJECTIVETo probe into the effective acupuncture technique for deviation of the mouth in intractable facial palsy.

METHODSOne hundred and one cases of intractable facial palsy were randomly divided into an observation group (48 cases) and a control group (53 cases). Cuanzhu (BL 2), Sibai (ST 2), Jiache (ST 6) and Qianzheng (Extra) on the affected side were punctured in two groups. Additionally, three acupoints of the mouth were supplemented, named Dicang (ST 4), Kouheliao (LI 19) and Jiachengjiang (Extra) were added, and the sticking needle and traction method was adopted on them in observation group. the routine needling technique was applied in control group. The treatment was given once a day and 10-day treatment made one session. The changes in facial nerve function index (FNFI) were observed in 2 sessions of treatment.

RESULTSAfter treatment, FNFI in two groups increased significantly (both P < 0.01), but the improvement in observation group was better than that in control group (P < 0.01). In observation group, the basic recovery rate of FNFI was 87.5% (42/48), which was higher than that (67.9%, 36/53) in control group (P < 0.05).

CONCLUSIONThe sticking needle and traction method o three points is the quite effective approach in the treatment of deviation of the mouth in intractable facial palsy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Face ; innervation ; Facial Nerve ; physiopathology ; Facial Paralysis ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Mouth ; Traction ; Young Adult

The calbindin D-28k (CB)-containing neurons in the interstitial nucleus of the spinal trigeminal tract (INV) that receive visceral and orofacial somatic nociceptive information and emanate projections to the parabrachial nuclei (PB) were investigated by the triple-labeled methods of fluorogold (FG) retrograde tracing combined with Fos and CB proteins immunofluorescence histochemistry in the rat. The results showed (1) in the perioral stimulation group, a large number of FG-retrograde labeled and Fos-immunoreactive neurons were found in the paratrigeminal nucleus (PaV) and the dorsal paramarginal nucleus (PaMd) of the INV ipsilateral to FG and formalin injection made to the PB and lips, respectively, while a lot of CB-immunoreactive neurons were distributed in the INV bilaterally; (2) a majority of the FG-retrograde labeled neurons (77.3%) were double-labeled with CB, and 40.7% of them were double-labeled with Fos; about 38.5% of FG/CB double-labeled neurons were FG/CB/Fos triple-labeled in the INV; and (3) in the upper alimentary tract stimulation group, the distribution and the numbers of FG-retrograde labeled, CB-immunoreactive neurons and FG/CB double-labeled neurons in the INV were similar to those of the perioral stimulation group as described above, except that the Fos immunoreactive neurons were distributed in the INV bilaterally, approximately 41.9% of the FG-retrograde labeled neurons were FG/Fos double-labeled, and over half (52.0%) of those double-labeled neurons were FG/CB/Fos triple-labeled. The results indicate that a part of CB-containing neurons in the INV receive orofacial somatic and visceral nociceptive information and that these neurons sent projections directly to the PB. The CB-containing neurons might play an important role in the transmission of the peripheral nociceptive information from INV to PB.
Animals ; Calbindins ; Face ; innervation ; Male ; Medulla Oblongata ; physiology ; Nerve Tissue Proteins ; metabolism ; Neural Pathways ; physiology ; Neurons ; metabolism ; physiology ; Nociceptors ; physiology ; Pain ; metabolism ; physiopathology ; Pons ; physiology ; Rats ; Rats, Sprague-Dawley ; S100 Calcium Binding Protein G ; metabolism ; Trigeminal Nucleus, Spinal ; physiology ; Viscera ; innervation