Anhidrosis in multiple system atrophy: A preganglionic sudomotor dysfunction?
Article first published online: 24 MAR 2008
Copyright © 2008 Movement Disorder Society
Volume 23, Issue 6, pages 885–888, 30 April 2008
How to Cite
Donadio, V., Nolano, M., Elam, M., Montagna, P., Provitera, V., Bugiardini, E., Baruzzi, A., Santoro, L. and Liguori, R. (2008), Anhidrosis in multiple system atrophy: A preganglionic sudomotor dysfunction?. Mov. Disord., 23: 885–888. doi: 10.1002/mds.21972
- Issue published online: 24 APR 2008
- Article first published online: 24 MAR 2008
- Manuscript Accepted: 10 JAN 2008
- Manuscript Revised: 8 JAN 2008
- Manuscript Received: 27 JUL 2007
- multiple system atrophy;
- skin biopsy;
- preganglionic sudomotor lesion
Anhidrosis occurs in the majority of multiple system atrophy (MSA) patients but the underlying site of lesion is not well established. We describe three patients with long-standing MSA and anhidrosis diagnosed on the basis of a thermoregulatory sweating test. In biopsies of anhidrotic skin, immunofluorescence analysis disclosed a well preserved postganglionic sudomotor innervation in all three patients supporting the hypothesis of a preganglionic nerve fiber lesion underlying their anhidrosis. Postganglionic sudomotor fiber integrity was also confirmed by normal electrodermal responses in one patient, whereas such responses and microneurographically detectable skin sympathetic nerve activity were absent in the other two MSA patients, suggesting a functional inactivity of structurally intact postganglionic sympathetic skin fibers. © 2008 Movement Disorder Society.