Severe compensatory hyperhidrosis after thoracic sympathectomy

Jeremy K. Cutsforth-Gregory, Robert D. Fealey, Francesco A. Harreld, Elizabeth Coon

Research output: Contribution to journalArticle

Abstract

A man was evaluated at age 35 years for burning/shooting pain in his left chest and drenching sweats affecting the lower trunk and legs since bilateral T2-T6 sympathectomy at age 22 for palmar and axillary hyperhidrosis. Thermoregulatory sweat test showed anhidrosis above T5/6 (sparing the left T2 dermatome) with rapid and profuse sweating elsewhere (figure). Severe compensatory hyperhidrosis is a known complication of extensive sympathectomy. Limited sympathotomy (disruption of fibers between stellate and T2 ganglia) or sympathectomy (e.g., T4 ganglionectomy) might be preferred for medically refractory palmar hyperhidrosis, maximizing palmar dryness, minimizing compensatory hyperhidrosis, and rarely causing intercostal neuralgia or Horner syndrome.1,2 Medical therapy for hyperhidrosis, whether primary or compensatory, may include topical agents, oral medications with anticholinergic properties, or botulinum toxin injections; all were unsuccessful or not tolerated in this patient.

Original languageEnglish (US)
Pages (from-to)e49-e50
JournalNeurology: Clinical Practice
Volume6
Issue number6
DOIs
StatePublished - Dec 1 2016

Fingerprint

Hyperhidrosis
Sympathectomy
Thorax
Sweat
Hypohidrosis
Ganglionectomy
Stellate Ganglion
Sweating
Botulinum Toxins
Cholinergic Antagonists
Neuralgia
Leg
Pain
Injections

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Severe compensatory hyperhidrosis after thoracic sympathectomy. / Cutsforth-Gregory, Jeremy K.; Fealey, Robert D.; Harreld, Francesco A.; Coon, Elizabeth.

In: Neurology: Clinical Practice, Vol. 6, No. 6, 01.12.2016, p. e49-e50.

Research output: Contribution to journalArticle

Cutsforth-Gregory, Jeremy K. ; Fealey, Robert D. ; Harreld, Francesco A. ; Coon, Elizabeth. / Severe compensatory hyperhidrosis after thoracic sympathectomy. In: Neurology: Clinical Practice. 2016 ; Vol. 6, No. 6. pp. e49-e50.
@article{fafc9877b25c4393b04431473ae0d96a,
title = "Severe compensatory hyperhidrosis after thoracic sympathectomy",
abstract = "A man was evaluated at age 35 years for burning/shooting pain in his left chest and drenching sweats affecting the lower trunk and legs since bilateral T2-T6 sympathectomy at age 22 for palmar and axillary hyperhidrosis. Thermoregulatory sweat test showed anhidrosis above T5/6 (sparing the left T2 dermatome) with rapid and profuse sweating elsewhere (figure). Severe compensatory hyperhidrosis is a known complication of extensive sympathectomy. Limited sympathotomy (disruption of fibers between stellate and T2 ganglia) or sympathectomy (e.g., T4 ganglionectomy) might be preferred for medically refractory palmar hyperhidrosis, maximizing palmar dryness, minimizing compensatory hyperhidrosis, and rarely causing intercostal neuralgia or Horner syndrome.1,2 Medical therapy for hyperhidrosis, whether primary or compensatory, may include topical agents, oral medications with anticholinergic properties, or botulinum toxin injections; all were unsuccessful or not tolerated in this patient.",
author = "Cutsforth-Gregory, {Jeremy K.} and Fealey, {Robert D.} and Harreld, {Francesco A.} and Elizabeth Coon",
year = "2016",
month = "12",
day = "1",
doi = "10.1212/CPJ.0000000000000294",
language = "English (US)",
volume = "6",
pages = "e49--e50",
journal = "Neurology: Clinical Practice",
issn = "2163-0402",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Severe compensatory hyperhidrosis after thoracic sympathectomy

AU - Cutsforth-Gregory, Jeremy K.

AU - Fealey, Robert D.

AU - Harreld, Francesco A.

AU - Coon, Elizabeth

PY - 2016/12/1

Y1 - 2016/12/1

N2 - A man was evaluated at age 35 years for burning/shooting pain in his left chest and drenching sweats affecting the lower trunk and legs since bilateral T2-T6 sympathectomy at age 22 for palmar and axillary hyperhidrosis. Thermoregulatory sweat test showed anhidrosis above T5/6 (sparing the left T2 dermatome) with rapid and profuse sweating elsewhere (figure). Severe compensatory hyperhidrosis is a known complication of extensive sympathectomy. Limited sympathotomy (disruption of fibers between stellate and T2 ganglia) or sympathectomy (e.g., T4 ganglionectomy) might be preferred for medically refractory palmar hyperhidrosis, maximizing palmar dryness, minimizing compensatory hyperhidrosis, and rarely causing intercostal neuralgia or Horner syndrome.1,2 Medical therapy for hyperhidrosis, whether primary or compensatory, may include topical agents, oral medications with anticholinergic properties, or botulinum toxin injections; all were unsuccessful or not tolerated in this patient.

AB - A man was evaluated at age 35 years for burning/shooting pain in his left chest and drenching sweats affecting the lower trunk and legs since bilateral T2-T6 sympathectomy at age 22 for palmar and axillary hyperhidrosis. Thermoregulatory sweat test showed anhidrosis above T5/6 (sparing the left T2 dermatome) with rapid and profuse sweating elsewhere (figure). Severe compensatory hyperhidrosis is a known complication of extensive sympathectomy. Limited sympathotomy (disruption of fibers between stellate and T2 ganglia) or sympathectomy (e.g., T4 ganglionectomy) might be preferred for medically refractory palmar hyperhidrosis, maximizing palmar dryness, minimizing compensatory hyperhidrosis, and rarely causing intercostal neuralgia or Horner syndrome.1,2 Medical therapy for hyperhidrosis, whether primary or compensatory, may include topical agents, oral medications with anticholinergic properties, or botulinum toxin injections; all were unsuccessful or not tolerated in this patient.

UR - http://www.scopus.com/inward/record.url?scp=85006173596&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006173596&partnerID=8YFLogxK

U2 - 10.1212/CPJ.0000000000000294

DO - 10.1212/CPJ.0000000000000294

M3 - Article

AN - SCOPUS:85006173596

VL - 6

SP - e49-e50

JO - Neurology: Clinical Practice

JF - Neurology: Clinical Practice

SN - 2163-0402

IS - 6

ER -