[Postganglionic sudomotor function in multiple system atrophy].
Postganglionic sudomotor function were examined on 12 patients with multiple system atrophy (MSA) consisting of 5 males and 7 females with the clinical duration of 1 to 10 years, and with the age ranged 51 and 70 years. Sixteen healthy volunteers, aged 38 to 75 years were also examined as the control. Local sweating induced by intradermal injection of pilocarpine and nicotine (a concentration of 10(-4) g/ml) was quantitatively measured on the volar surface of the forearm and lower lateral leg using a ventilated capsule method in a climatic chamber at 23 degrees C and 40% of relative humidity. Maximal sweat rate induced by nicotine and pilocarpine was significantly reduced in patients with MSA as compared with controls in both the forearm and lower lateral leg. MSA cases associated with more prominent autonomic dysfunction as well as hyposweating, showed a more remarkable impairment of local sweat responses. Particularly, in 6 cases with Shy-Drager syndrome, there was no sweat response by the injection of both pilocarpine and nicotine. The study of an autopsied case with Shy-Drager syndrome revealed neurons in the para-vertebral sympathetic ganglia were well populated, though neurons in the lateral horns of the lower thoracic spinal cord were almost completely depleted. This substantial discrepancy between the impaired sudomotor function and morphological findings may imply several hypothetical views on the mode of pathology of postganglionic sudomotor nerves. The present results, however, strongly suggested that postganglionic sudomotor functions are more extensively involved in patients with MSA than had ever been believed.(ABSTRACT TRUNCATED AT 250 WORDS)
Kumazawa
K
K
Sobue
G
G
Nakao
N
N
Mitsuma
T
T
D000328:Adult; D000368:Aged; D001284:Atrophy; D001341:Autonomic Nervous System / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009849:Olivopontocerebellar Atrophies / Q000473:pathology / Q000503:physiopathology; D012791:Shy-Drager Syndrome / Q000503:physiopathology*; D013545:Sweat Glands / Q000473:pathology*; D013546:Sweating / Q000502:physiology*