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Since Harlequin syndrome is associated with a dysfunction in the autonomic nervous system, main symptoms of this dysfunction are in the following: Absence of sweat and flushing on one side of the face, neck, or upper thoracic area. In addition, other symptoms include cluster headaches, tearing of the eyes, nasal discharge, abnormal contraction ...
Early symptoms include intense pain in one ear, the jaw on one side or the neck on one side which may precede the acute facial paralysis by a week or more. Acute symptoms include: acute facial nerve paralysis; pain in the ear, jaw and/or neck; taste loss in the front two-thirds of the tongue; dry mouth and eyes
They occur mostly in the orbital, supraorbital, or temporal region, but can also occur in the retro-orbital (behind the orbit of the eye) region, side, top, and back of head, second and third trigeminal divisions, teeth, neck, and ear. Only a negligible percentage of attacks (less than 2%) occur at night. [3]
The pain occurs only on one side of the head, around the eye, particularly behind or above the eye, in the temple. The pain is typically greater than in other headache conditions, including migraines , and is usually described as burning, stabbing, drilling or squeezing. [ 15 ]
The pain is usually constant, described as aching or burning, and often affects both sides of the face (this is almost never the case in patients with trigeminal neuralgia). The pain frequently involves areas of the head, face, and neck that are outside the sensory territories that are supplied by the trigeminal nerve.
A migraine attack often causes severe throbbing pain or a pulsing sensation, usually on one side of the head. But migraine attacks are complex, and not everyone will have the same set of symptoms.