The bullet that hit a nerve: the history of Lucja Frey and her syndrome

Abstract

Duphenix first described gustatory sweating in 1757. The underlying pathogenesis was not appreciated until 1923, when Lucja Frey, a Polish neurologist, observed the phenomenon in a Polish soldier with an infected bullet wound in the parotid gland and suggested that the auriculo-temporal nerve played a role. Lucja Frey was born in Lwów, Poland, in 1889 and began her medical studies in Lwów before moving to Warsaw to work as a neurologist. She amassed a total of 43 publications on various neurological topics over her career. Unfortunately, during the Second World War she was enlisted into the Lwów ghetto, where she worked until her death in 1943. We present the history of Frey's syndrome, particularly the life of Lucja Frey and the syndrome she described.

Unilateral gustatory flushing in a teenager

“…This explains why erythema and hyperhidrosis may be seen in response to gustatory stimuli 1 . This syndrome was first fully elucidated in 1923 by Lucja Frey, a Polish neurologist, when she observed the clinical sign in a soldier with an infected bullet wound in his parotid gland 2 …”

“…1 This syndrome was first fully elucidated in 1923 by Lucja Frey, a Polish neurologist, when she observed the clinical sign in a soldier with an infected bullet wound in his parotid gland. 2 In adults, UGF most commonly follows trauma, such as radical neck dissection or surgery in the parotid area. 1 In children, the exact incidence is unknown although it is reported as rare.…”

Frey syndrome

“…[6] Although most of these nerves have norepinephrine as their primary mediator, the fibers leading to the sweat glands are sympathetic cholinergic fibers. [3,19,20] Lucia-Frey syndrome is a known and frequently described complication occurring as a result of damage to the auriculotemporal nerve containing fibers of the autonomic system that affect the secretion of saliva in the parotid gland and the secretion of sweat from the sweat glands, and dilatation and constriction of blood vessels in the pre-ear and temporal areas of the scalp. [7,19,21] Destruction of nerve fibers may occur during craniofacial injuries, parotidectomy, forceps delivery, thoracic sympathectomy or burns.…”