The Syndrome of the Auriculotemporal Nerve
Among the several atypical facial pains or pseudoneuralgias there occasionally occurs a peculiar disturbance of the auriculotemporal nerve when this structure becomes involved in parotid abscesses or fistulae. Since parotid abscess is not an unusual complication of typhus fever and since this disease is endemic in eastern Europe, it is only natural that the first description of the condition was reported from Russia and Poland. Frey,1 after whom the syndrome is frequently named, reported the first authentic case in 1923, although brief consideration was given to the same disorder by Lipsztat2 in a Polish journal the year before. In 1931 Fridberg3 cited three examples of the disease in Russian women from Moscow, all in connection with parotitis complicating typhus.
This singular nerve lesion occurs in the wake of an abscess of the parotid gland, but the symptoms may not develop until several years after the original process has healed. Whenever the patient starts to eat, particularly if the food is hot, spicy, dry, or sour, the cheek over the parotid area turns red, and drops of perspiration appear on it. Occasionally the beads of perspiration are so prominent that they give the impression that a chronic parotid fistula is present and that the moisture is saliva. At the same time a feeling of fullness and flushing on the affected side of the face is experienced, while the mucous membrane of the corresponding buccal cavity feels unusually dry. These phenomena do not usually result from the mere movement of mastication unless. . .