Frey's Syndrome: Treatment with Botulinum Toxin

Abstract

The effectiveness of botulinum toxin injections for the management of Frey's syndrome was studied. Botulinum toxin A (approximately 0.5 Units/cm2) was injected intracutaneously into the affected skin area as determined by Minor's starch iodine test. Gustatory sweating in the treated skin area ceased completely within 1 week and has not reappeared (12 months follow up until now in the first treated case). There have been no side effects. It is concluded that local botulinum toxin injections are a highly effective and safe treatment for Frey's syndrome. Additional study is required to evaluate the duration of the therapeutic effect.

Focal Hyperhidrosis

“…In gustatory sweating, which frequently occurs after posttraumatic misdirection of the regenerating parasympathetic fibers to the sweat glands, botulinum toxin treatment abolished sweating for more than 12 months. 10 This finding is in agreement with our experience in a large group of patients with gustatory sweating in whom a single injection had an anhidrotic effect that lasted at least 6 months. 11 In the present study,…”

Treatment of gustatory hyperlacrimation (crocodile tears) with injection of botulinum toxin into the lacrimal gland

“…Prior to its use in the treatment of CTS it has been used similarly in Frey's syndrome (gustatory sweating) to stop transmission of impulses along aberrant autonomic nerve fibres to the sweat glands. [10][11][12] The first reports describing the use of BTX-A in the treatment of gustatory hyperlacrimation appear in the literature in 1998. Boroojerdi et al 6 initially published two cases of patients who had reflex lacrimation treated in this way.…”

Frey syndrome treatment with botulinum toxin☆

“…1,11 So far, the available treatments have either been of temporary benefit or are associated with potential side effects that are more important than the symptoms to be treated. The treatment of Frey syndrome with botulinum toxin injection, following a suggestion of Drobik and Laskawi, 24 appears an attractive option. …”