title: Harlequin syndrome in a patient with putative autoimmune autonomic ganglionopathy.
abstract: The author presents a patient with Harlequin and Horner syndromes as part of an autoimmune autonomic ganglionopathy and suggests implication for work-up and management. In general, Harlequin and Horner syndromes are reported to be caused by either a structural lesion of the sympathetic pathway or, when no structural lesion is found, are presumed to be idiopathic. In this paper, a 76 year old man developed a Harlequin and Horner syndromes in the setting of subacute autonomic failure and other systemic features. The patient's symptoms improved with a short course of intravenous methylprednisolone. An autoimmune etiology should be considered in patients with Harlequin syndrome and immunomodulatory treatment could be attempted, especially when there is evidence of a more generalized autoimmune autonomic ganglionopathy.
authors.affiliation: Department of Neurology, The University of North Carolina at Chapel Hill, United States. Electronic address: chafickaram@gmail.com.
authors.forename: Chafic
authors.initials: C
authors.lastname: Karam
mesh_terms: D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000473:pathology; D004576:Electromyography; D005483:Flushing / Q000150:complications* / Q000473:pathology; D045888:Ganglion Cysts / Q000473:pathology*; D006801:Humans; D007007:Hypohidrosis / Q000150:complications* / Q000473:pathology; D008297:Male; D009431:Neural Conduction / Q000502:physiology; D011129:Polyradiculoneuropathy / Q000150:complications* / Q000473:pathology
keywords: All Immunology; Autoimmune diseases; Dysautonomia; Harlequin syndrome; Horner's