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Autonomic Disorders in Parkinsonism
Published in M.D. Francesco Amenta, Peripheral Dopamine Pathophysiology, 2019
Wade L. Collier, Francesco Amenta
Disturbed sweating is a common symptom in patients with Parkinson’s disease; in fact it is one of the most frequently occurring autonomic nervous system disorders.33 Usually, patients complain of diffuse excessive sweating. The most common sites of sweating are the upper part of the body, especially on the face bilaterally. Some patients, however, are bothered by decreased sweating, especially on the lower portions of the body, as well as heat intolerance. Appenzeller and Goss34 reported that 8 of 18 patients with Parkinson’s disease had normal thermoregulatory sweating. The other ten patients had almost complete anhidrosis on the limbs and trunk and compensatory hyperhidrosis on the face. A different study35 discovered that 4 of 11 Parkinsonian patients had complete anhidrosis over the neck, trunk and limbs.
Botulinum toxin in the management of focal hyperhidrosis
Published in Anthony V. Benedetto, Botulinum Toxins in Clinical Aesthetic Practice, 2017
David M. Pariser, DeeAnna Glaser
Compensatory sweating is the most common complication of endoscopic transthoracic sympathectomy (ETS), ranging from 44% to 91%.106 Treatment has been particularly difficult but a few reports have noted success using BoNTA. Huh used 300 U OnaBTX-A to treat the chest and abdomen after identifying the area with an iodine-starch test.106 He diluted each 100 U of OnaBTX-A with 10 mL saline and injected 0.1 mL into each square centimeter. The effects gradually reduced but were reported to remain for 8 months. Belin and Polo reported good results treating the upper abdomen with OnaBTX-A, but unfortunately their patient's compensatory sweating was from the nipple line down to his knees and the entire area was not treated.37 Kim and colleagues reported on 17 patients with severe compensatory hyperhidrosis being treated with BoNTA.98 One hundred to 500 units of OnaBTX-A were used, administering 2 units every 1.5 cm. The injections were well-tolerated, but the authors noted incomplete resolution of the sweating due to insufficient dosing, and the duration lasted only 4 months.107 The major drawback of treating compensatory HH with BoNT is the quantity of drug that needs to be administered.
Video-assisted thoracoscopic surgery (VATS) sympathectomy
Published in Larry R. Kaiser, Sarah K. Thompson, Glyn G. Jamieson, Operative Thoracic Surgery, 2017
Young K. Hong, M. Blair Marshall
VATS sympathectomy is a definitive, safe, and effective treatment for patients who suffer from craniofacial, palmar, or axillary hyperhidrosis, with the highest success rate reserved for those suffering from hand sweating. Various techniques such as electrocautery lesions, resection, and clip placement have been used for blockade of the sympathetic chain at the appropriate level corresponding to a patient’s symptoms. Compensatory hyperhidrosis is a known and common side effect and should be discussed in detail with the patient preoperatively. By using minimally invasive methods and bilateral intercostal nerve blocks, and there being a lack of intrapleural drainage, the procedure may be performed in an ambulatory setting with patients being discharged home on the same day and experiencing immediate relief of their embarrassing social problem.
A survey of long-term results with microwave energy device for treating axillary hyperhidrosis
Published in Journal of Cosmetic and Laser Therapy, 2021
Matthew J. Lin, Danielle P. Dubin, Jordan Genece, Shannon Younessi, Sweta Rai, Hooman Khorasani
Although there are many treatment options available to treat axillary hyperhidrosis, in our experience, these modalities do not have the same degree of patient satisfaction as the microwave device. Temporary treatments, such as topical aluminum, topical glycopyrrolate, oral anticholinergics, topical anticholinergics, or botulinum toxin, either require frequent application or are associated with a significant financial or time cost (11,12). Permanent treatments include radical surgical excision, liposuction, and endoscopic thoracic sympathectomy(13). These procedures are usually effective, but may be associated with long recovery times, scarring, and retraction. Sympathectomy in particular is associated with compensatory hyperhidrosis, which has been reported to occur in as many as 94% of patients. New and promising treatments for axillary hyperhidrosis include the neodymium-doped yttrium aluminum garnet laser (transcutaneous and subdermal), fractionated microneedle radiofrequency treatment, and high-intensity micro-focused ultrasound (14–17).
A case series evaluating microwave-based therapy for axillary hyperhidrosis and bromhidrosis
Published in Journal of Dermatological Treatment, 2022
Abdiweli Awil Mohamoud, Lina Zeraiq, Tine Vestergaard
Although axillary hyperhidrosis and bromhidrosis are different diseases that involve different glands, their treatment is similar. They have a distressing effect on human interaction and a negative impact on the quality of life. Nonpermanent treatments such as injections and oral medications have unwanted adverse effects and are expensive and temporary. Invasive treatments, such as surgical intervention provide long term management of the problem but are often associated with a high degree of compensatory hyperhidrosis (2,5–7). Although good efficacy has been reported for laser treatment, insertion of the laser fiber into the subdermal space may lead to complications if the procedure is not well conducted (8).
Selective block of grey communicantes in upper thoracic sympathectomy. A feasibility study on human cadaveric specimens
Published in British Journal of Neurosurgery, 2020
Vicente Vanaclocha, Nieves Sáiz Sapena, Marlon Rivera, Juan Manuel Herrera, José María Ortiz-Criado, Ana Monzó-Blasco, Ricardo Guijarro-Jorge, Leyre Vanaclocha
Postoperatively, patients are initially satisfied with the cessation of sweating from hands and axillae.3 Two months postoperatively, patients could start to notice excessive sweating in areas where they previously did not, such as the abdomen, chest, buttocks, and thighs. This is what is known as compensatory hyperhidrosis (CH) or compensatory sweating. It is the main reason for post-operative patient dissatisfaction.4–6 CH affects three-quarters of patients, but it is particularly problematic for one-third of the patients.