title: Resolution of Postural Orthostatic Tachycardia Syndrome After CT-Guided, Percutaneous T2 Ethanol Ablation for Hyperhidrosis.
abstract: Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experienced resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome.
authors: Department of Thoracic Surgery, Center for Sweat Disorders, Johns Hopkins University, Baltimore, USA.
authors: Malcolm
authors: M
authors: Brock
authors: Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, USA.
authors: Tae Hwan
authors: TH
authors: Chung
authors: Vascular & Interventional Radiology, Johns Hopkins University, Sheikh Zayed Tower-Suite 7203, 1800 Orleans Street, Baltimore, MD, 21287, USA.
authors: Sathvika Reddy
authors: SR
authors: Gaddam
authors: Vascular & Interventional Radiology, Johns Hopkins University, Sheikh Zayed Tower-Suite 7203, 1800 Orleans Street, Baltimore, MD, 21287, USA.
authors: Anjaneya Singh
authors: AS
authors: Kathait
authors: Department of Thoracic Surgery, Johns Hopkins University, Baltimore, USA.
authors: Cecily
authors: C
authors: Ober
authors: Vascular & Interventional Radiology, Johns Hopkins University, Sheikh Zayed Tower-Suite 7203, 1800 Orleans Street, Baltimore, MD, 21287, USA. cgeorgi@jhmi.edu.
authors: Christos
authors: http://orcid.org/0000-0002-4559-1639
authors: C
authors: Georgiades
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000368:Aged; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000150:complications / Q000628:therapy*; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D000431:Ethanol
keywords: Autonomic dysregulation; Hyperhidrosis; POTS; Postural orthostatic tachycardia syndrome; Sympatholysis