Sympathetic skin responses recorded from non-palmar and non-plantar skin sites: their role in the evaluation of thermal sweating.
OBJECTIVE
To characterize the sympathetic skin responses (SSRs) recorded from non-palmar and non-plantar (non-Pa/P1) skin sites and to evaluate their clinical usefulness.


METHODS
SSRs were recorded from 6 non-Pa/P1 sites as well as palmar and plantar (Pa/P1) sites using magnetic neck stimulation in 33 normal subjects, 17 neurological patients with dysautonomia and one patient with lumbar sympathectomy. A conventional thermoregulatory sweat test (TST) was also carried out in 3 patients.


RESULTS
Clear and reproducible SSRs were obtained from all recording sites in all of the normal subjects when the skin temperatures of the subjects were maintained above 34 degrees C and the subjects drank 100-200 ml of hot water. The distribution of absent SSRs was closely correlated with that of anhidrosis or a sweating delay shown by the TST in the patients. Nine of the 17 neurological patients (53%) showed normal responses at Pa/P1 sites, and abnormal responses at non-Pa/P1 sites.


CONCLUSIONS
Recording SSRs from multiple skin sites including non-Pa/P1 sites after magnetic stimulation is more sensitive in detecting sudomotor dysfunction than is the conventional method of recording SSRs from only Pa/P1 sites. In addition, this new method is very useful for the objective clinical evaluation of thermal sweating.
Matsunaga
K
K
Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu City, Fukuoka, Japan.
Uozumi
T
T
Tsuji
S
S
Murai
Y
Y
D000326:Adrenoleukodystrophy / Q000175:diagnosis / Q000503:physiopathology; D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology; D001827:Body Height; D004558:Electric Stimulation; D005260:Female; D005712:Galvanic Skin Response; D006225:Hand / Q000294:innervation*; D006358:Hot Temperature; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D011930:Reaction Time / Q000502:physiology; D012867:Skin / Q000294:innervation*; D013546:Sweating / Q000502:physiology*; D013564:Sympathetic Nervous System / Q000502:physiology*; D013919:Thromboangiitis Obliterans / Q000175:diagnosis / Q000503:physiopathology