Posted by: Indonesian Children | October 18, 2010

Sindrom Auriculotemporal atau Sindrom Frey’s Sebagai Manifestasi Alergi Makanan

Sindrom Auriculotemporal atau Sindrom Frey’s  Sebagai Manifestasi Alergi Makanan

Abstract

Auriculotemporal or Frey syndrome is characterized mainly by recurrent episodes of facial gustatory flushing and/or sweating, limited to the cutaneous distribution of the auriculotemporal nerve. Although relatively common in adults following injury to the auriculotemporal nerve or parotid disease, the condition has rarely been reported in children. Moreover, in childhood, auriculotemporal syndrome has been described mainly in infancy and early childhood as a sequel of perinatal birth trauma resulting from assisted forceps delivery. An unusual presentation of auriculotemporal syndrome in late childhood as gustatory flushing mimicking food allergy. Adverse food reactions are common complaints to the general pediatrician. True hypersensitivity reactions are only a small part of the overall incidence of reactions. Other conditions that are initially thought to be food allergies include enzyme deficiencies, food poisoning, and pharmacologic agents in foods. Awareness of this variant is essential for prompt recognition, thus avoiding unnecessary laboratory tests, especially as this condition usually resolves spontaneously.

Sindrom Auriculotemporal sering juga disebut Sindrom Frey’s,  gangguan ini bisa karena bawaan genetik atau  operasi parotis dan dapat bertahan sampai seumur hidup. Gejala-gejala sindrom Frey adalah kemerahan dan berkeringat pada daerah pipi yang berdekatan dengan telinga. Beberapa kasus ternyata saat timbul manifestasi tersebut berkaitanm dengan konsumsi makan tertentu.
Sindrom Auriculotemporal nerupakan gangguan neurologis yang jarang. Gangguan ini akibat cidera saat operasi dekat kelenjar parotis (yang memproduksi air liur), merusak saraf wajah. Kelenjar parotid merupakan kelenjar ludah terbesar dan terletak di sisi wajah di bawah ini dan di depan telinga. Sindrom ini ditandai dengan pembilasan atau berkeringat pada satu sisi wajah ketika makanan tertentu yang dikonsumsi. Gejala biasanya ringan dan ditoleransi dengan baik oleh kebanyakan individu. Perbaikan gejala mungkin memerlukan bantuan obat dan penghindaran makan yang memicu memperberat gejalanya.
Nama Lain Sindrom Auriculotemporal :
  • Auriculotemporal Syndrome
  • Baillarger’s Syndrome
  • Dupuy’s Syndrome
  • Salivosudoriparous Syndrome
  • Sweating Gustatory Syndrome
  • von Frey’s Syndrome
Sindrom Auriculotemporal sering diakibatkan karena efek samping dari operasi kelenjar parotis. Cabang Auriculotemporal dari saraf Trigeminal membawa serat simpatis ke kelenjar keringat kulit kepala dan serat parasimpatis ke kelenjar parotid. Sebagai hasil dari pesan dan regenerasi yang tidak tepat, serat dapat beralih program, sehingga menghasilkan “Gustatory Sweating” atau berkeringat saat mengantisipasi makan, Keadaan ini bukan respon salivatory normal. Hal ini sering terlihat dengan pasien yang telah menjalani simpatektomi dada endoskopi, sebuah prosedur operasi dimana bagian dari batang simpatik dipotong atau dijepit untuk mengobati keringat dari tangan atau memerah. Regenerasi berikutnya atau saraf tumbuh menyebabkan berkeringat abnormal dan air liur. Hal ini juga dapat mencakup debit dari hidung ketika mencium makanan tertentu.
De Benedittis G (1990)  dalam laporan ilmiah kasus melaporkan kasus sindrom saraf auriculotemporal (sindrom Frey) yang disertai tic douloureux. Kondisi ini, ditandai dengan berkeringat gustatory dan hiperemi wajah, kadang-kadang berhubungan dengan nyeri, yang biasanya digambarkan sebagai sakit atau terbakar, dan tahan lama. Sakit gustatory tersebut membuat gangguan nyeri yang menyiksa bersifat  paroxysms singkat
Penanganan
  • Identifikasi dan hindari makanan penyebab
  • Injeksi  botulinum toxin type A
  • Tindakan bedah  transection of the nerve fibers
  • Diberi obat oles topikal ointment yang mengandung  anticholinergic seperti scopolamine
Daftar Pustaka
  • Sethuraman G, Mancini AJ. Familial auriculotemporal nerve (Frey) syndrome. Pediatr Dermatol. 2009 May-Jun;26(3):302-5.
  • SUZANNE A. BECK MD1, A. WESLEY BURKS MD1, , ROBERT C. WOODY MD1. Auriculotemporal Syndrome Seen Clinically as Food Allergy PEDIATRICS Vol. 83 No. 4 April 1989, pp. 601-603
  • Kaddu S,Smolle J, Komericki P, Kerl H.Auriculotemporal (Frey) syndrome in late childhood: an unusual variant presenting as gustatory flushing mimicking food allergy. Pediatr Dermatol. 2000 Mar-Apr;17(2):126-8.
  • Croner 5, Kyellman NM, Ericksson B, et al: IgE screening in 1701 newborn infants and the development of atopic disease during infancy. Arch Dis Child 1982;57:364
  • Bock SA, Martin M: The incidence of adverse reactions to foods-A continuing study. J Allergy Chin Immunob 1983;71:98
  • Harper KE, Speilvogel RL: Frey’s syndrome. mt J Dermatob 1986;25:524
  • Frey L: Le syndrome du nerf auriculotemporal. Rev Neurob 1923;2:97
  • Freeddberg AS, Shaw RS, McManus MJ: The auriculotemporal syndrome: A clinical and pharmacologic study. J ChinInvest 1948;27:669
  • Glaister DH, Hearnshaw JR, Heffron PF, et al: The mechanism of postparotidectomy gustatory sweating (the auriculotemporal syndrome). Br Med J 1958;2:942
  • Dizon MV, Fischer G, Jopp-McKay A, Treadwell PW, Paller AS. Localized facial flushing in infancy. Auriculotemporal nerve (Frey) syndrome. Arch Dermatol. 1997 Sep;133(9):1143-5. Review.
  • Clarós P, González-Enseñat MA, Arimany J, Vincente MA, Clarós A. Frey syndrome in childhood. Acta Otorrinolaringol Esp. 1993 Sep-Oct;44(5):385-6. Spanish.
  • Davis RS, Strunk RC: Auriculotemporal syndrome in childhood. Am J Dis Child 1981;135:832
  • De Benedittis G. Auriculotemporal syndrome (Frey’s syndrome) presenting as tic douloureux. Report of two cases. J Neurosurg. 1990 Jun;72(6):955-8.
  • Sly RM: Auriculotemporal syndrome. Cutis 1981;28:423
  • Weidman Al, Nathan D, Franks AG: Gustatory sweating associated with unilateral hyperpigmentation. Arch Dermatob1969;99:734
  • Bednarek J, Reid W, Matsumoto T: Frey’s syndrome. Am JSurg 1976;131:592
  • Fenichel GM, Swaiman KF, and Wright FS: Neuromuscular Disease, in Swaiman KF, Wright FS (eds): The Practice ofPediatric Neurology, ed 2 St Louis, CV Mosby Co, 1982, p1268
  • Miller NR: Walsh and Hoyt’s Clinical Neuro-Ophthalmology, in Miller NE (ad): Tumors of Cranial and PeripheralNerves, ed 4. Baltimore, Williams & Wilkins, 1988, vol 2, pp 1557
Provided by
dr Widodo judarwanto SpA, pediatrician
Children’s Allergy Center Online
Picky Eaters Clinic, Klinik Kesulitan makan Pada Anak

Office : JL Taman Bendungan Asahan 5  Jakarta Pusat  Phone : (021) 70081995 – 5703646email :  judarwanto@gmail.com, www.childrenallergyclinic.wordpress.com/  

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Responses

  1. […] Sindrom Auriculotemporal atau Sindrom Frey’s Sebagai Manifestasi Alergi Makanan […]

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