Definition
The Frey syndrome is also called Gustatory sweating, Gustatory hyperhidrosis or Auriculotemporal syndrome. It is an extremely pronounced sweating of the skin in the face and neck area, which is triggered during eating or any other gustatory stimulus. Triggers can be the eating of any kind of food, but also candy sucking, tasting, chewing or biting. This disease owes its name to the Polish physician Lucja Frey-Gottesman, who described the syndrome in 1923. However, there are already earlier descriptions of “taste sweating”.
Causes of Frey syndrome
Frey’s syndrome is caused by a misdirection in the nervous system. It is damage to vegetative, parasympathetic nerve fibers and the incorrect docking of sympathetic fibers to the sweat glands. A branch of the nerve, the chorda tympani of the facial nerve, which serves to secrete saliva, is misdirected.
This faulty nerve contact can be the result of trauma or surgery, for example. Surgical removal of the salivary glands (parts), peripheral facial paresis or inflammation of the salivary glands such as the parotid gland or the mandibular parotid gland can cause Frey’s syndrome. It is assumed that during the operation or trauma parasympathetic nerve fibers are damaged, which supply the sweat glands in healthy people.
After this trauma or operation, new nerve fibers are formed in the area. In the process, sympathetic nerve fibers dock erroneously on the sweat glands, so that they are stimulated by all gustatory stimuli. One sweats heavily with any form of eating, chewing or tasting. Furthermore, there are described cases in which the Frey syndrome already shows after birth. In most cases the cause has been evaluated as birth trauma.
Diagnosis of Frey’s syndrome
Frey’s syndrome is diagnosed on the basis of the clinical symptoms. The iodine strength test according to Minor is also available as a diagnostic tool, which makes sweating skin regions visible. This test colors the regions and makes them treatable, for example with botulinus toxin.
