# Harlequin Syndrome Caused by Multinodular Goitre

## TL;DR

This paper discusses a rare case of Harlequin syndrome caused by a multinodular goitre, highlighting its neurological effects and differences from Horner’s syndrome.

## Contribution

The novelty lies in presenting a rare case of Harlequin syndrome linked to a non-toxic multinodular goitre and providing a detailed neuroanatomical review.

## Key findings

- Harlequin syndrome was caused by compression of the sympathetic trunk from a multinodular goitre.
- The case highlights the importance of distinguishing Harlequin syndrome from Horner’s syndrome.
- The paper provides insights into sympathetic facial innervation for physicians.

## Abstract

Harlequin syndrome is a rare neurological disorder characterised by hemifacial flushing and sweating. We present a case of Harlequin syndrome with evidence of compression of the sympathetic trunk due to a non-toxic multinodular goitre. We review the neuroanatomy of this fascinating condition, particularly in relation to the more common and often sinister Horner’s syndrome, to convey a deeper understanding of the nuances of sympathetic facial innervation to the keen physician.