Vicc,


You asked about the name of the disorder in which there is unilateral flushing with marked deliniation.---The disease is called Harlequin Syndrome. This is a disease in which there is neurovascular compression of the sympathetic chain.
I have seen this several times in my career.
There are numerous sites on the disorder, one being www.nature.com/ncpneuro/journal/v1/full/ncpneuro.


You also asked whether I thought that redness can ONLY be caused by sympathetic dysfunction? I can't imagine what would make you ask that because I acknowledged that inflammation and infection also cause redness of the skin. In fact it is probably the most usual cause, it just was NOT the cause in the story that Sandel posted.

I am quite confused with the diagnosis of IRI as I believed it was describing the damage done to tissue when it has been reperfused following a period of ischaemia and am wondering how this equates to a nerve disease?
I know and have seen IRI and yes there can be some nerve damage but we should not confuse the peripheral nerve damage that may occur due to death by ischaemia with the nervous systom dysfunction that occurs in RSD/CRPS.
The blood supply to our skin is regulated by our autonomic/sympathetic system, whether it be vasoconstriction or vasodilation (which causes the flushing)
It stands to reason if there is prolonged or frequent vasoconstriction then there maybe tissue damage as a result---this is obvious in the trophic changes we often have.


You have also stated that nerve blocks are an ineffectual method of treating RSD/CRPS and there is usually relapse.
Vicc, whilst this may be your experience (I am not sure if you have had blocks or not) but there are many documented stories from people on this site from people who have had great success with them and it IS well documented that EARLY intervention with blocks is known to bring about a remission or cure for some people.
It seems that the ability of the patient to get prompt and appropriate attention from a well informed, proactive medical team is tantamount to the outcome.


Tayla