Sato K, Nitta E
Department of Neurology, Kanazawa National Hospital.
Rinsho Shinkeigaku. 2000 Mar;40(3):271-3.
This report concerns a 88-year-old diabetic and hypertensive woman with pontine hemorrhage who presented with Foville syndrome and contralateral hyperhidrosis. She was admitted to our hospital for sudden onset of headaches and disturbed consciousness. Neurologic examination revealed bilateral miosis, Foville syndrome and superficial hemianesthesia on the right side of the face and body. No associated Horner syndrome and other autonomic dysfunction were observed. Laboratory data were normal except for diabetic findings. Brain CT and MRI revealed a hematoma in the left side at the lower pons. One month after the onset, hemihyperhidrosis on the face, arm and upper trunk contralateral side of the lesion appeared abruptly, and gradually disappeared a week later. Sweating on the ipsilateral side was normal and no new lesion was seen on the brain CT then. Only a few cases of contralateral hyperhidrosis due to pontine lesion have been reported. We suggest that the contralateral inhibitory sweating pathway was disrupted though the ipsilateral excitatory one was intact. Contralateral hyperhidrosis attributed to imbalance of the perspiratory control can be observed in the subacute or late phase after pontine hemorrhage.
本报告涉及一名88岁的糖尿病和高血压女性，患有脑桥出血，表现为福维尔综合征和对侧多汗。她因突发头痛和意识障碍入院。神经系统检查发现双侧瞳孔缩小、福维尔综合征以及右侧面部和身体浅感觉减退。未观察到相关的霍纳综合征和其他自主神经功能障碍。除糖尿病相关检查结果外，实验室数据均正常。脑部CT和MRI显示左脑桥下部有血肿。发病一个月后，病变对侧的面部、手臂和上躯干突然出现偏侧多汗，一周后逐渐消失。同侧出汗正常，当时脑部CT未发现新病变。仅有少数因脑桥病变导致对侧多汗的病例报道。我们认为，尽管同侧兴奋性出汗通路完整，但对侧抑制性出汗通路受到了破坏。脑桥出血亚急性期或后期可观察到因出汗控制失衡导致的对侧多汗。
