Harlequin syndrome after jogging

Agustín Toll and Alberto Gálvez-Ruiz
Med J Aust 2011; 195 (5): 288. || doi: 10.5694/mja11.10572
Published online: 5 September 2011

A 35-year-old man sent us this self-portrait, taken with a digital camera, showing significant asymmetric flushing on the left side of his face after jogging. The episode resolved spontaneously after 30 minutes of rest. Harlequin syndrome consists of flushing limited to one side of the face due to sympathetic disturbance on the contralateral side.1 Although most cases are benign, imaging and neurological examination should be performed in patients with this condition to rule out serious structural lesions of the sympathetic pathway, such as mediastinal neurinoma, spinal invasion by lung cancer and brainstem infarction.

  • Agustín Toll1
  • Alberto Gálvez-Ruiz2

  • Hospital del Mar, Barcelona, Spain.


  • 1. Wasner G, Maag R, Ludwig J, et al. Harlequin syndrome — one face of many etiologies. Nat Clin Pract Neurol 2005; 1: 54-59.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.