Recordings of pre- and postoperative sympathetic skin response in patients with palmar hyperhidrosis.
Transthoracic endoscopic sympathectomy is an accepted standard surgical treatment for hyperhidrosis palmaris. During the past 4 years, more than 500 patients underwent this kind of surgical treatment at our institution with a 98% success rate. About 50% of cases were found to have compensatory sweating. We measured the sympathetic skin response (SSR) and R-R interval variation (RRIV) in 38 normal control subjects, and 50 consecutive patients with palmar hyperhidrosis before and 2 weeks after transthoracic endoscopic T2-3 sympathectomy. Before sympathectomy SSR was absent in 36% of patients on deep inspiratory stimulation and in 20% on electrical stimulation. After T2-3 sympathectomy, SSR in the palms was absent in 64% of patients with deep inspiration stimulation and in 76% on electrical stimulation. A decrease in the SSR amplitude in the soles was found in 40% on deep inspiration and in 54% of patients on electrical stimulation. RRIV was not significantly influenced 2 weeks after sympathectomy. The high abnormal rate of SSR in the patient group indicated that an abnormal regulation of the sudomotor control center played an important role in palmar hyperhidrosis.
Chen
H J
HJ
Department of Neurosurgery, Chang Gung Medical College, Taiwan, R.O.C.
Cheng
M H
MH
Lin
T K
TK
Chee
E C
EC
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004558:Electric Stimulation; D004724:Endoscopy; D005260:Female; D005712:Galvanic Skin Response; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D013562:Sympathectomy; D013564:Sympathetic Nervous System / Q000502:physiology* / Q000601:surgery