Ann Clin Neurophysiol.  2019 Jan;21(1):1-6. 10.14253/acn.2019.21.1.1.

Neurological aspects of anhidrosis: differential diagnoses and diagnostic tools

• Park KH
• Park KJ

• KMID: 2434181
• DOI: http://doi.org/10.14253/acn.2019.21.1.1

Abstract

Anhidrosis refers to the condition in which the body does not respond appropriately to thermal stimuli by sweating. Sweating plays an important role in maintaining the body temperature, and its absence should not be overlooked since an elevated body temperature can cause various symptoms, even leading to death when uncontrolled. The various neurological disorders that can induce anhidrosis make a detailed neurological evaluation essential. The medication history of the patient should also be checked because anhidrosis can be caused by various drugs. The tests available for evaluating sweating include the quantitative sudomotor axon reflex sweat test, thermoregulatory sweat test, sympathetic skin response, and electrochemical skin conductance. Pathological findings can also be checked directly in a skin biopsy. This review discusses the differential diagnosis and evaluation of anhidrosis.

Keyword

Anhidrosis; Sweating; Autonomic nervous system

MeSH Terms

Autonomic Nervous System
Axons
Biopsy
Body Temperature
Diagnosis, Differential*
Humans
Hypohidrosis*
Nervous System Diseases
Reflex
Skin
Sweat
Sweating

Figure

• 

  Fig. 1. Thermoregulatory sweat test results for a patient with acquired idiopathic generalized anhidrosis. (A) Sweating was absent from the entire skin. (B) Systemic corticosteroid therapy induced partial improve-ment of sweating (area indicated in purple).

• 

  Fig. 2. Example results from quantitative sudomotor axon reflex sweat tests. Forearm, sky blue; proximal leg, red; distal leg, purple; foot, blue. (A) Nor-mal results. (B) Diabetic neuropathy with length-dependent results. (C) Pure autonomic failure in the presence of generalized anhidrosis.

Reference

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