title: Botulinum toxin A for palmar hyperhidrosis: assessment with sympathetic skin responses evoked by train of stimuli.
abstract: Objective assessment of the effect of botulinum toxin A (BT) treatment in primary palmar hyperhidrosis (PH) is attempted by different methods. We decided to use for this purpose sympathetic skin responses evoked by train of stimuli (TSSR). Twenty patients with severe PH (five female, median age 24, range 18-36) were examined regularly over 3 months after receiving 50 UI BT in each palm. TSSR were recorded from the palms after sensory stimulation by a train of three supramaximal electric pulses 3 millisecond apart. Results were compared to longitudinally studied TSSR of 20 healthy sex- and age-matched control subjects. All hyperhidrosis patients reported excellent improvement. TSSR amplitudes decreased at week 1 (mean 54% range 48%-67%) and over the following months in a clinically significant trend (slope R=-.82, P<.0001). TSSR in controls changed insignificantly (±13% from the baseline). The difference between patients and controls was highly significant at any time point (P<.001). This study suggests that TSSR may help in assessment of treatments in PH. It confirms objectively the efficacy of BT in PH.
authors.affiliation: Ibn Sina Hospital, Safat, Kuwait.
authors.forename: J Y
authors.initials: JY
authors.lastname: Al-Hashel
authors.affiliation: Ibn Sina Hospital, Safat, Kuwait.
authors.forename: D
authors.initials: D
authors.lastname: Youssry
authors.affiliation: Ibn Sina Hospital, Safat, Kuwait.
authors.forename: H M
authors.initials: HM
authors.lastname: Rashaed
authors.affiliation: Neurosurgery, Military Medical Academy, Sofia, Bulgaria.
authors.forename: T
authors.initials: T
authors.lastname: Shamov
authors.affiliation: Ibn Sina Hospital, Safat, Kuwait.
authors.forename: R T
authors.initials: RT
authors.lastname: Rousseff
mesh_terms: D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004576:Electromyography / Q000379:methods; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects / Q000502:physiology*; D005260:Female; D005712:Galvanic Skin Response / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D006945:Hyperhidrosis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D007271:Injections, Intradermal; D008137:Longitudinal Studies; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D013564:Sympathetic Nervous System / Q000187:drug effects / Q000502:physiology; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: botulinum toxin; primary palmar hyperhidrosis; sympathetic skin response