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Focal (segmental) dyshidrosis in syringomyelia
  1. Kazumasa Sudo,
  2. Naoto Fujiki,
  3. Sachiko Tsuji,
  4. Minoru Ajiki,
  5. Takuya Higashi,
  6. Masaaki Niino,
  7. Seiji Kikuchi,
  8. Fumio Moriwaka,
  9. Kunio Tashiro
  1. Department of Neurology, Hokkaido University School of Medicine, Sapporo, Japan
  1. Dr Kazumasa Sudo, Department of Neurology, Hokkaido University School of Medicine, Kita 14, Nishi 5, Kita-Ku, Sapporo, 060–8648 Japan. Telephone 0081 11 716 1161, ext 6028; fax 0081 11 700 5356; emailsudo{at}med.hokudai.ac.jp

Abstract

The features or mechanisms of dyshidrosis have not been sufficiently clarified. Neither has the difference between hyperhidrosis and hypohidrosis. To clarify the features and mechanisms of dyshidrosis (hyperhidrosis and hypohidrosis) in syringomyelia, the clinical features focusing on hidrosis of 30 patients with syringomyelia and Chiari malformation located from a syringomyelia database were prospectively analysed. The patients were classified into three groups: eight patients (26.7%) had segmental hypohidrosis, 10 (33.3%) had segmental hyperhidrosis, and 12 (40.0%) had normohidrosis. We found that the Karnofsky functional status for the hyperhydrosis and normohidrosis groups were significantly higher than for the hypohidrosis group (p=0.0012), with no significant differences between the hyperhidrosis and normohidrosis groups. The duration from the onset of syringomyelia to the current dyshidrosis was significantly longer in the hypohidrosis group than in the hyperhidrosis group (p=0.0027). A significant correlation was identified between the duration from the onset of syringomyelia to the time at study and the performance score (r=−0.599, p=0.0003). The results substantiate previous hypotheses that in its early stage syringomyelia causes segmental hyperactivity of the sympathetic preganglionic neurons, and hyperactivity of these gradually subsides as tissue damage progresses. Focal hyperhidrosis may be regarded as a hallmark of a relatively intact spinal cord, as well as normohidrosis.

  • syringomyelia
  • Chiari malformation
  • dyshidrosis
  • sympathetic preganglionic neuron

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