Hemihyperhidrosis in cerebral infarction

Abstract

Increased sweating on the hemiparetic side in cerebral infarcts is not a common clinical finding. The onset, severity and duration of symptoms can vary. The structural lesion responsible for this is a subject of conjecture. We present the case of a 66-year-old man who developed hemihyperhidrosis secondary to a cerebral infarct.

Unilateral Hemihyperhidrosis in a Stroke Patient and Literature Review on Its Clinicoanatomical Correlation

“…Contralateral hyperhidrosis is rarely reported in the stroke literature, with an incidence around 1% in thalamic 16 , hypothalamic 17 , pontine 7 -9, 18 , medulla oblongata 10,11 , and cerebral hemispheric 10,12,13 infarction. However, it has received scant attention in hemiplegic patients after subcortical stroke.…”

“…Significant asymmetry in sweating occurred in 29 of the 40 patients (73%, asymmetry sweating was observed in 73% of patients in the acute phase of infarction, 56% after 1 month and 85% after 6 months. In term of management, most post-stroke hyperhidrosis cases do not require treatment as it is a benign and self-limiting disorder 12 . Awada et al (1991) 26 inferred that the duration of hyperhidrosis may be related to the site of the nervous lesions and compensatory mechanisms are much stronger in higher lesions.…”

“…The pathogenesis of this phenomenon was conjectured to the disruption of sudomotor fibres in the intersected inhibitory hypothalamospinal sympathetic path that supply the sweat glands. Unilateral hyperhidrosis secondary to anterior circulation cerebral infarcts is a rare clinical finding 12 and only limited studies have been found in patients with large cortical stroke involving the opercular cortex, cortical and subcortical structures 10,12,13 . Hyperhidrosis itself interferes with quality of life 14 .…”