Bilateral gustatory sweating as a sign of diabetic neuropathy This is a report of a case of diabetic gustatory sweating that appeared as the initial sign of autonomic neuropathy in a patient undergoing periodontal therapy. A 73-year-old white male presented for periodontal evaluation and treatment of localized severe PerIodontitis. The patient revealed a four- to five-year history of sweating while eating and drinking. Sweating was bilateral and was initiated by eating almost all foods. The symptoms could be elicited by sucking on two lemon drops. The patient had no history of trauma or surgical therapy in the head and neck region. Frey's syndrome was ruled out by a complete intraoral and extraoral examination. Frey's syndrome is generally characterized by localized unilateral gustatory sweating which has been related to aberrant anastomoses between parasympathetic secretomotor fibers previously responsible for controlling the secretory response and sympathetic fibers destined for facial sweat glands. Patient was diagnosed with Type II diabetes mellitus in 1967 at age 47 years. After the initial dental exam the patient was referred to the neurology department with a provisional diagnosis of diabetic autonomic neuropathy. The final neurologic diagnoses were chronic distal sensorimotor polyneuropathy and autonomic neuropathy manifesting as gustatory sweating and were deemed to be long-term complications of the patient's diabetic condition. No treatment was required. Periodontal therapy was initiated to resolve the periodontitis. [A.E.I.]
Mealey, B.L., OS, OM, OP, 77:113, 1994