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Harlequin syndrome following upper lobectomy
Nabil Hussein1, Yama Haqzad1, Joshil Lodhia1
1Cardiothoracic Surgery Department, Castle Hill Hospital, Cottingham, UK.
Asian Cardiovascular & Thoracic Annals
|February 8, 2018
Summary
A patient experienced Harlequin syndrome, characterized by unilateral facial flushing and sweating, after thoracic surgery and a paravertebral block. Symptoms resolved completely during follow-up, indicating a likely temporary neurological response.
Area of Science:
- Neurology
- Thoracic Surgery
- Anesthesiology
Background:
- Thoracic surgery, specifically upper lobectomy, carries potential neurological complications.
- Paravertebral blocks are used for postoperative pain management but can rarely affect autonomic pathways.
Observation:
- A 58-year-old female presented with acute unilateral facial flushing and sweating on the left side.
- These symptoms occurred immediately following a right thoracotomy and upper lobectomy with paravertebral block.
Findings:
- The patient was diagnosed with Harlequin syndrome, a rare condition causing temporary facial autonomic dysfunction.
- No other neurological deficits were observed, supporting the diagnosis of isolated Harlequin syndrome.
Implications:
- This case highlights a rare, transient neurological complication associated with thoracic surgery and paravertebral anesthesia.
- Understanding such adverse events is crucial for accurate diagnosis and patient management in thoracic procedures.
- Prompt recognition and supportive care can lead to complete recovery from Harlequin syndrome.
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