title: Frey Syndrome.
abstract: OBJECTIVE
  To describe the features of Frey syndrome (auriculotemporal nerve dysfunction with gustatory flushing) in childhood.
  
  
  METHODS
  A multicenter, retrospective, descriptive observational national case series study was conducted with the help of French academic societies. Diagnostic criteria were based on clinical history, and sometimes also on photographs or provocation tests.
  
  
  RESULTS
  Forty-eight cases were identified, with 2 subtypes: 35 unilateral and 13 bilateral. Associated sweating was reported in only 10% of cases. Diagnosis was made in only 20% of children at the first consultation and inappropriate dietary restriction was prescribed for 21%. Instrumented vaginal delivery was significantly associated with unilateral forms (OR [unilateral vs bilateral] = 29; 95% CI 3.99-311.58; P < .001). The outcome was favorable overall with 57% regression, 20% recovery, and only 23% persistence of initial symptoms. Regression was more frequent in unilateral forms (OR = 6.60; 95% CI 1.23-44.04; P = .016), observed in 69% of unilateral forms at a median age of 27 (24-48) months. Recovery predominated in bilateral forms (OR = 0.05; 95% CI 0-0.38; P = .001), observed in 58% of bilateral cases at a median age of 8 (7-9) months.
  
  
  CONCLUSIONS
  Frey syndrome in childhood is a rare but benign condition with mild symptoms and a favorable outcome in most cases. Unilateral forms are mostly associated with instrumented delivery. Pediatricians should be familiar with this disorder in order to avoid misdiagnosis, mainly as food allergy, and unnecessary referrals and tests.
authors.affiliation: Pediatric Pulmonology and Allergy Department, Hôpitaux pédiatriques de Nice University Hospital-Lenval, Nice, France.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Blanc
authors.affiliation: Pediatric Pulmonology and Allergy Department, Hôpitaux pédiatriques de Nice University Hospital-Lenval, Nice, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Bourrier
authors.affiliation: Pediatric Dermatology Unit, Hôpital Pellegrin-enfants, Bordeaux University Hospital, Bordeaux, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Boralevi
authors.affiliation: Pediatric Department, Hôpital Américain, Reims, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Sabouraud-Leclerc
authors.affiliation: Allergy Department, Institut Pasteur, Paris, France; University Paris 5 Descartes, Paris, France.
authors.forename: Nhân
authors.initials: N
authors.lastname: Pham-Thi
authors.affiliation: Pediatric Department, Hôpital Charles Nicoles, Rouen, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Couderc
authors.affiliation: Pediatric Pulmonology and Allergy Department, Clinique de pédiatrie Jeanne de Flandre, Lille University Hospital, Lille, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Deschildre
authors.affiliation: 9 rue Maurice-Alet, Toulouse, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Dutau
authors.affiliation: Pediatric Pulmonology and Allergy Department, Hôpitaux pédiatriques de Nice University Hospital-Lenval, Nice, France; Université de Nice-Sophia Antipolis, Nice, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Albertini
authors.affiliation: Pediatric Emergency Department, Hôpitaux pédiatriques de Nice CHU-Lenval, Nice, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Tran
authors.affiliation: Pediatric Pulmonology and Allergy Department, Hôpitaux pédiatriques de Nice University Hospital-Lenval, Nice, France; Université de Nice-Sophia Antipolis, Nice, France.
authors.forename: Lisa
authors.initials: L
authors.lastname: Giovannini-Chami
mesh_terms: D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies; D013547:Sweating, Gustatory / Q000150:complications / Q000175:diagnosis* / Q000628:therapy
keywords: auriculotemporal syndrome; child; food allergy; infant; instrumental delivery