Patchy sweating in the thermoregulatory sweating test indicates postganglionic sympathetic dysfunction or an impairment of the eccrine sweat glands: with special reference to Parkinson’s disease and multiple system atrophy

Abstract

To understand the pathophysiological significance of patchy sweating in the thermoregulatory sweat test (TST), its incidence was assessed in the following disease groups: A, subjects without somatic and autonomic signs (Control: 120); B, idiopathic pure sudomotor failure (6); C, polyneuropathy (85); D, Ross or Adie syndromes (9); E, brainstem lesions (50); F, spinal lesions (51); G, Parkinson’s disease (PD:136); H, multiple system atrophy (MSA:39). Subjects with diabetes mellitus were excluded except in group C. Patchy sweating was not observed in A or E, but it’s incidence was 100 % in B, 63% in C, 78% in D, 2% in E, 51% in G, and 87% in H. These results suggest that patchy sweating in TST may indicate postganglionic sympathetic dysfunction or an impairment of the eccrine sweat glands. Furthermore, postganglionic sympathetic dysfunction may occur with high frequency not only in Parkinson’s disease but also in multiple system atrophy.