Development of Harlequin Syndrome following placement of thoracic epidural anesthesia in a pediatric patient undergoing Nuss procedure.

We report the development of Harlequin Syndrome following thoracic epidural placement in a pediatric patient. Unilateral facial flushing with contralateral pallor and anhidrosis is the clinical presentation. This syndrome is typically benign. When related to regional anesthesia, treatment involves reducing the local anesthetic infusion or stopping it altogether.