SEARCH · PubMed Health

Results for “Hyperhidrosis”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources

PubMed1998

Thoracoscopic T2-sympathetic block by clipping--a better and reversible operation for treatment of hyperhidrosis palmaris: experience with 326 cases.

Although thoracoscopic sympathectomy or sympathicotomy is the best treatment for hyperhidrosis palmaris, a new approach of clipping only without transection of T2-sympathetic trunk is just as effective. Aside from the guaranteed cure of hyperhidrosis, this new method has fewer complications and has the advantage of recovery of the sympathetic tone in the hands if the procedure is reversed by the removal of the clips. Between March 18 and September 30 of 1996, 326 patients (190 female and 136 male with a mean age of 20.5 years) underwent thoracoscopic T2-sympathetic block by clipping to treat hyperhidrosis. Good results and few complications were noted during follow up six months to one year postoperatively. Five of the 326 patients, all female, had the operation reversed because of intolerable compensatory sweating. Three recovered from the compensatory sweating within two months and had less palmar sweating than before their sympathetic block; the fourth achieved relief of compensatory sweating after nine months, and the fifth reported no improvement.

Adolescent↗

PubMed1996

A simplified T2-T3 thoracoscopic sympathicolysis technique for the treatment of essential hyperhidrosis: short-term results in 100 patients.

A simplified one-time bilateral thoracoscopic T2-T3 sympathicolysis technique using single-lumen endotracheal intubation with high frequency jet ventilation and electrocautery destruction ("sympathicolysis") of the sympathetic ganglia was applied in 100 consecutive patients with severe essential hyperhidrosis (EH). Providing a pleural space can be created, this technique was proven simple and safe, and short-term clinical results were excellent: palmar hyperhidrosis was cured in 98% of patients, and axillar and plantar improvement was achieved in 62 and 65% of patients, respectively. Side-effects and complications were minor (compensatory hyperhidrosis) or self-limiting (pain). These data confirm the safety and efficacy of thoracoscopic sympathetic interventions for the treatment of EH, and support the evolution toward simplified methodologies.

Adolescent↗

PubMed1994

Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limbs. A critical analysis and long-term results of 480 operations.

OBJECTIVE: This evaluated the long-term outcome after endoscopic thoracic sympathectomy (ETS) from below D1 to D4, using a single-site access technique for primary hyperhidrosis of the upper limbs. SUMMARY BACKGROUND DATA: Primary hyperhidrosis of the upper limbs is a distressing and often socially disabling condition. Endoscopic thoracic sympathectomy is considered the treatment of choice, causing minimal morbidity and high initial success rates. However, data regarding long-term results are scarce. METHODS: Two hundred seventy of 323 patients (83.7%), in whom 480 sympathectomies were performed, answered a questionnaire after a mean of 14.6 years postoperatively regarding the early postoperative result, side effects, and complications caused by the operation and long-term results with particular emphasis on patient satisfaction. RESULTS: There was no postoperative mortality and no major complications requiring surgical reintervention. A majority of the patients (98.1%) were relieved, and 95.5% were satisfied initially. Permanent side effects included compensatory sweating in 67.4%, gustatory sweating in 50.7% and Horner's trias in 2.5%. However, patient satisfaction declined over time, although only 1.5% recurred. This left only 66.7% satisfied, and a 26.7% partially satisfied. Compensatory and gustatory sweating were the most frequently stated reasons for dissatisfaction. Individuals operated for axillary hyperhidrosis without palmar involvement were significantly less satisfied (33.3% and 46.2%, respectively).

Adolescent↗

PubMed1991

Neuropeptides in skin disease: increased VIP in eczema and psoriasis but not axillary hyperhidrosis.

The neuropeptides vasoactive intestinal polypeptide (VIP), substance P and somatostatin were studied in skin biopsies from patients with eczema, psoriasis and axillary hyperhidrosis. VIP concentrations were elevated in skin affected by eczema and psoriasis, whereas substance P and somatostatin levels did not differ from controls. There was a higher concentration of VIP, but not of substance P or somatostatin, in normal axillary skin when compared to adjacent trunk skin, with abundant VIP-containing fibres surrounding eccrine sweat glands. The VIP concentration was unchanged in skin affected by axillary hyperhidrosis. VIP may increase local blood flow in eczema and psoriasis, but does not appear to play a role in axillary hyperhidrosis.

Adult↗

PubMed2003

A double-blind, randomized, comparative study of Dysport vs. Botox in primary palmar hyperhidrosis.

BACKGROUND: Intradermal injections of type A botulinum toxin have been reported to reduce excessive sweating in patients with primary palmar hyperhidrosis. Two preparations are commercially available in Europe: Botox (Allergan; 100 U per vial) and Dysport (Beaufour Ipsen Biotech; 500 U per vial), which are not bioequivalent. A few studies have tried to find an appropriate conversion factor between the two preparations in dystonic patients but results remain controversial. OBJECTIVES: To compare the efficacy of Botox and Dysport in palmar hyperhidrosis using a conversion factor of 1 : 4. METHODS: In a double-blind, randomized study, eight patients with severe primary palmar hyperhidrosis received in the same session intradermal injections of Dysport in one palm and Botox in the other, after regional median and ulnar nerve blocks. Quantification of sweat production was performed by Minor's iodine starch test at baseline, 1, 3 and 6 months after the treatment. Subjective assessment of sweat production was performed using a visual analogue scale. RESULTS: The mean +/- SD number of injection sites (28 +/- 1), mean volume of reconstituted solution injected (2.8 mL) and mean sweating area at baseline (BSA) were similar in each palm group. The mean +/- SD dose injected was 69.3 +/- 3.1 U for the Botox-treated palms and 283.7 +/- 11.3 U for the Dysport-treated palms (1 : 4). At 1 month, Minor's test revealed significant decreases in mean sweating area for each preparation (Dysport palms: -78.6% vs. BSA, P = 0.0002; Botox palms: -56.6% vs. BSA, P = 0.003). The percentage of decrease was more pronounced in Dysport palms compared with Botox palms but the difference did not reach statistical significance. At 3 months, the decrease in sweating area remained significant for Dysport palms (-69.4% vs. BSA, P = 0.008) but not for Botox palms (-48.8% vs. BSA). Self-evaluation showed a similar amount of improvement in both palm groups at 1 and 3 months (77% and 75% for Dysport; 68% and 72% for Botox). Local side-effects were more frequent in Dysport palms (weakness of thumb-index pinch in four cases, lasting 8-30 days) than in Botox palms (weakness of thumb-index pinch in two cases, lasting 15-21 days). The mean duration of positive effect was similar: 17 weeks in Dysport (range 8-32) and 18 weeks in Botox palms (range 8-32). CONCLUSIONS: Using a conversion factor of 1 : 4, the efficacy of Botox and Dysport injections was similar. However, there was a trend towards a larger improvement after Dysport treatment but with a higher incidence of adverse effects.

Adult↗

PubMed2006

Quantitative effect of anodal current in the treatment of primary hyperhidrosis by direct electrical current.

AIM: To determine the quantitative effect and technique of use of the anodal current for the treatment of palmoplantar hyperhidrosis on local areas of the palms and soles. METHODS: Twelve patients (four males and eight females) with idiopathic palmoplantar hyperhidrosis were enrolled in this study. Having determined the initial sweat intensities of both hands using the pad glove method, direct electrical current (d.c.) treatment was applied to the palms of the patients using a complete regulated d.c. unit for which the current and potential ranges were 0-30 mA and 0-90 V, respectively. Electrodes were placed into two separate water plates, and covered with pad made from gauze and cotton material. The pads were moisturized with tap water for current conduction. The anodal current was applied to the right hands of six patients (group I) and to the left hands of the remainder (group II). After seven treatments had been completed for the palms, the final sweat intensities of the hands were measured. RESULTS: In both groups, the final sweat intensities of the hands subjected to the anodal current were significantly decreased in comparison with the initial values, regardless of whether the anodal current was applied to the right or left hand (P < 0.05). In contrast, the final sweat intensities of the other hands subjected to the cathodal current were not significantly decreased (P > 0.05). CONCLUSIONS: It can be concluded that the anodal current is more effective in reducing sweating on the palms when applied either to the right or left hand. In the treatment of palmoplantar or localized hyperhidrosis, the anodal current should be referenced first to treat the sweatier hand or foot, or a local hyperhidrotic area of the skin. The selection of the anodal current for one hand for the first five or seven sessions appears to be more effective than the use of polarity changes for each session.

Adolescent↗

PubMed1997

Essential hyperhidrosis in Turner syndrome.

We describe two Turner patients suffering from severe essential hyperhidrosis. Since both disorders are rare (1 in 5000 live female births for Turner syndrome and approximately 1 in 1000 persons for essential hyperhidrosis), our finding of two patients with these disorders in a total of 150 essential hyperhidrosis patients may suggest that this association is more frequent in Turner syndrome than previously thought.

Child↗

PubMed1990

Posttraumatic headache with ptosis, miosis and chronic forehead hyperhidrosis.

Injury to the right lateral forehead was followed by headaches, and chronic ipsilateral ptosis, miosis, and forehead hyperhidrosis. Episodes of headache were accompanied by an increase in ptosis, miosis and forehead hyperhidrosis. The headaches abated within 6 weeks but the ptosis and miosis, due to postganglionic sympathetic insufficiency, were persistent. Spontaneous forehead hyperhidrosis, was also persistent at the time of last follow-up, 15 months later. Autonomic assessment of the oculocephalic sympathetic dysfunction, localization of the lesion and possible explanation of the autonomic findings are discussed.

Adult↗

PubMed2001

Botulinum toxin type A in treatment of bilateral primary axillary hyperhidrosis: randomised, parallel group, double blind, placebo controlled trial.

OBJECTIVES: To evaluate the safety and efficacy of botulinum toxin type A in the treatment of bilateral primary axillary hyperhidrosis. DESIGN: Multicentre, randomised, parallel group, placebo controlled trial. SETTING: 17 dermatology and neurology clinics in Belgium, Germany, Switzerland, and the United Kingdom. PARTICIPANTS: Patients aged 18-75 years with bilateral primary axillary hyperhidrosis sufficient to interfere with daily living. 465 were screened, 320 randomised, and 307 completed the study. INTERVENTIONS: Patients received either botulinum toxin type A (Botox) 50 U per axilla or placebo by 10-15 intradermal injections evenly distributed within the hyperhydrotic area of each axilla, defined by Minor's iodine starch test. MAIN OUTCOME MEASURES: Percentage of responders (patients with >/=50% reduction from baseline of spontaneous axillary sweat production) at four weeks, patients' global assessment of treatment satisfaction score, and adverse events. RESULTS: At four weeks, 94% (227) of the botulinum toxin type A group had responded compared with 36% (28) of the placebo group. By week 16, response rates were 82% (198) and 21% (16), respectively. The results for all other measures of efficacy were significantly better in the botulinum toxin group than the placebo group. Significantly higher patient satisfaction was reported in the botulinum toxin type A group than the placebo group (3.3 v 0.8, P<0.001 at 4 weeks). Adverse events were reported by only 27 patients (11%) in the botulinum toxin group and four (5%) in the placebo group (P>0.05). CONCLUSION: Botulinum toxin type A is a safe and effective treatment for primary axillary hyperhidrosis and produces high levels of patient satisfaction.

Adolescent↗

PubMed2000

Cardiac autonomic function in patients suffering from primary focal hyperhidrosis.

Cardiac autonomic function in patients (n = 63) with primary focal hyperhidrosis and healthy controls (n = 28) was investigated by short-term frequency domain power spectral analysis of heart rate variability. The power of the very-low-frequency band (0.01-0.05 Hz) was significantly lower in patients with axillary hyperhidrosis than in controls. No differences between groups could be observed at investigation of the low-frequency band (0.05-0.15 Hz), which was a surprising finding because this band represents also sympathetic cardiac innervation. At the high-frequency band (0.15-0.5 Hz), which represents parasympathetic cardiac innervation, an interaction of type and position influencing spectral power was detected. Our highly interesting findings indicate that primary focal hyperhidrosis is based on a much more complex autonomic dysfunction than generalised sympathetic overactivity and seems to involve the parasympathetic nervous system as well.

Adult↗

PubMed2001

Treatment of idiopathic palmar hyperhidrosis with botulinum toxin. Report of 23 cases and review of the literature.

BACKGROUND: Botulinum toxin represents a novel therapeutic option for idiopathic palmar hyperhidrosis. However, so far there is no consensus on the way to administer botulinum toxin in this indication. Moreover, its use is limited by severe pain during the injections, especially with subepidermal injections close to 'free nerve endings'. OBJECTIVES: To analyze the effectiveness and tolerability of intracutaneous injections of botulinum toxin after nerve blocks and to review the techniques of injections and the results reported by other groups. METHODS: Twenty-three adult patients with refractory palmar hyperhidrosis were treated with intracutaneous injections of botulinum toxin after ulnar and median nerve blocks. Patients were followed up on a monthly basis. RESULTS: In all patients botulinum toxin abolished sweating in the injected areas within 1 week. Anhidrosis lasted for 4-13 months. The intensity of pain was rated as absent (n = 13), mild (n = 8) or moderate (n = 2). Other side effects included hematoma (n = 2) and pain consecutive to nerve block (n = 1). DISCUSSION: Intracutaneous injections of botulinum toxin after median and ulnar nerve block represent an effective and mildly painful technique to treat palmar hyperhidrosis and may be as safe as subepidermal injections.

Adolescent↗

PubMed1995

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.

Adolescent↗

PubMed1995

Segmental hyperhidrosis in two siblings with Chiari type I malformation.

A marked, left-sided segmental hyperhidrosis, verified by quantitative evaporimetry, corresponded to an area of dissociated sensory loss in 2 siblings (male 49 years old, female 47 years old). MRI scans of the head and whole cord demonstrated a Chiari type I malformation in both. In the male, there was a syrinx of the neck. The level of this did not correspond to the hyperhidrosis and dissociated sensory loss areas of the trunk and thigh. The female, who had no syrinx, had hyperhidrosis and dissociated sensory loss of the head, neck, upper trunk, and arm, and anisocoria with the larger pupil ipsilateral to the sweating. This rare disorder may be due to a disinhibition of the preganglionic sympathetic neurons caused by cord lesion(s) interrupting inhibitory descending and spinal pathways which are important for the normal thermoregulatory sweating.

Arnold-Chiari Malformation↗

PubMed1987

Long-term efficacy and side effects of tap water iontophoresis of palmoplantar hyperhidrosis--the usefulness of home therapy.

Treatment of palmoplantar hyperhidrosis was carried out with a conventional galvanic generator in 40 patients and with a newly developed iontophoresis apparatus, which is suited for home treatment, in 31 patients. The new apparatus is operated by a rechargeable energy source or by batteries and is disconnected from the electrical net during treatment. It conforms to most recent safety regulations as approved by Underwriter's Laboratory. Hyperhidrosis was completely controlled after 10-12 treatments as revealed by quantitative gravimetric measurements of sweat rates and semiquantitative estimation of starch iodine paper imprints. There was no apparent difference in efficacy between the two apparatuses. Not only hyperhidrosis was abolished, but associated symptoms, such as lividity of palms or soles, acral hypothermia and edema of fingers or toes, also subsided. Skin temperature on palms rose from 29.7 +/- 1.8 degrees C before treatment to 32.2 +/- 1.4 degrees C thereafter. Maintenance treatment was continued on an average for 14 months, in 4 patients for more than 3 years. No loss of efficacy was found during that period. Side effects were minimal and depended upon amperage used. Only slight discomfort during treatment and mild short-lasted skin irritation were observed. Long-term side effects did not occur.

Adolescent↗

PubMed1992

Hyperhidrosis as a reflection of autonomic failure in patients with acute hemispheral brain infarction. An evaporimetric study.

BACKGROUND AND PURPOSE: Sweating dysfunction is one of the most frequently encountered symptoms of autonomic failure but has received scant attention in patients with cerebrovascular diseases. Our purpose was to evaluate the prevalence, pathogenesis, and clinical correlates of sweating dysfunction in stroke. METHODS: We studied sweating at baseline and after a heating stimulus in 53 patients with acute hemispheral brain infarction and in 40 healthy control subjects by using a quantitative evaporimetric method. RESULTS: Significant hyperhidrosis on the paretic side of the body was verified in 55% of the patients at baseline, in 74% after 5 minutes of heating, and in 77% after 10 minutes of heating. Hyperhidrosis was established throughout the body and correlated with the severity of paresis, the presence of reduced muscle tone, and the extensor plantar response. CONCLUSIONS: The phenomenon of hyperhidrosis in hemiparetic patients reflecting autonomic dysfunction seems to be a common manifestation that should be listed among the expected consequences of brain infarction. This sweating disturbance might be attributed to a lesion of a putative sympathoinhibitory pathway controlling sweating. The failure of this pathway could also be related to other manifestations of sympathetic hyperfunction, e.g., cardiac complications. Therefore, assessment of sweating may provide a new, important aspect in the evaluation of stroke patients.

Acute Disease↗

PubMed1988

Unilateral hyperhidrosis after cerebral infarction.

Unilateral hyperhidrosis occurred contralateral to acute cerebral infarctions in six patients. Two patients had localized infarctions of opercular cortex, while the other four had large strokes involving both superficial cortical and deep subcortical structures. The unilateral hyperhidrosis typically involved the face and arm and was transient, lasting 1 to 3 days. No other autonomic dysfunction occurred. One patient died, and the others had significant residual neurologic disability, thus indicating poor prognosis when this sign is present. Disruption of a pathway of cortical origin, inhibitory to contralateral sweating, is a proposed mechanism for the hyperhidrosis seen contralateral to acute cerebral infarction in these patients.

Adult↗

PubMed2004

Endoscopic thoracic sympathectomy suppresses baroreflex control of heart rate in patients with essential hyperhidrosis.

UNLABELLED: Endoscopic thoracic (T2-3 or T3-4) sympathectomy (ETS) is a highly effective treatment for palmar hyperhidrosis. Because the T2-3 or T3-4 sympathetic ganglia are involved in direct sympathetic innervation of the heart, sympathectomy at this level may alter baroreflex control of heart rate. The purpose of our study was to examine the influence of ETS on baroreflex responses to pressor and depressor stimuli under small-dose sevoflurane anesthesia. We studied 40 patients with palmar or axillary hyperhidrosis who were scheduled to receive ETS. In the ETS procedure, the sympathetic trunk was identified by using thoracic endoscopy and was transected. Before and after ETS, the pressor or depressor test was performed by using an IV infusion of phenylephrine or nitroglycerin, respectively, under small-dose general anesthesia. Baroreflex sensitivity was calculated from R-R intervals and systolic blood pressure. ETS did not change heart rate and systemic blood pressure at rest, although ETS significantly altered baroreflex in both pressor and depressor tests in all patients. Baroreflex was completely suppressed in 1 of 19 patients in the pressor test and in 9 of 21 patients in the depressor test. We conclude that baroreflex responses are suppressed in patients who receive ETS. IMPLICATIONS: Endoscopic thoracic sympathectomy suppressed the baroreflex control of heart rate during pressor and depressor tests in patients with palmar or axillary hyperhidrosis.

Adult↗

PubMed2005

Video-assisted sympathectomy for essential hyperhidrosis: effects on cardiopulmonary function.

BACKGROUND: Essential hyperhidrosis is characterized by overactivity of the sympathetic fibers passing through the upper-dorsal ganglia (second and third thoracic ganglia [D2-D3]), and the treatment of choice is video-assisted thoracoscopy sympathectomy. Alterations in cardiopulmonary function after treatment have been reported. STUDY OBJECTIVE: To evaluate cardiopulmonary function impairment after sympathectomy in patients with essential hyperhidrosis. DESIGN AND SETTING: Prospective controlled trial at a pulmonary function unit of a university hospital. PATIENTS: Twenty patients (2 men and 18 women) with essential hyperhidrosis. MEASUREMENTS AND RESULTS: Pulmonary function tests, including spirometry and thoracic gas volume, bronchial challenge with methacholine, and maximal exercise, were performed before and 3 months after D2-D3 sympathectomy. Video-assisted sympathectomy was performed using a one-stage bilateral procedure with electrocoagulation of D2-D3 ganglia. Pulmonary function values (spirometrics and volumes) were not statistically different in the two groups. The maximal midexpiratory flow was the only variable that showed significant changes, from 101% (SD, 26%) to 92% (SD, 27%) [p < 0.05]. Ten patients had positive bronchial challenge test results that remained positive 3 months after surgery, and 2 patients whose challenge test results were negative before surgery became positive after sympathectomy. Significant reductions in maximal heart rate (HR) and oxygen and carbon dioxide uptakes were observed during the maximal exercise test. CONCLUSIONS: Video-assisted thoracoscopy is a safe treatment, and the observed modifications in cardiopulmonary function only suggest a minimal small airway alterations in the presence of positive bronchial hyperresponsiveness and mild sympathetic blockade in HR. The clinical importance of these findings is not significant.

Adolescent↗