Alnuaimi Khulood, Asapu Preethi, Tahtamoni Rafeef, Sudha Resshme, Alao David O
Department of Emergency Medicine, Tawam Hospital, Al Ain, United Arab Emirates.
Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
J Med Case Rep. 2025 Jul 1;19(1):296. doi: 10.1186/s13256-025-05375-z.
Hyperhidrosis is common. History, physical examination, and simple investigations are often sufficient to confirm the diagnosis. However, hyperhidrosis can result from focal autonomic seizures. Diagnosing focal autonomic seizures is challenging, and there is a high rate of misdiagnosis.
A 59-year-old Emirati man presented with intermittent sweating episodes and fatigue of 3 weeks duration. Initial differential diagnoses included poorly controlled diabetes, hyperthyroidism, and cardiac arrhythmia. A focal autonomic seizure was suspected after visits to five different specialities. A diagnosis of temporal glioblastoma was confirmed on an magnetic resonance imaging scan. The patient had surgical removal of the tumor, and his symptoms resolved after treatment with levetiracetam and dexamethasone.
Hyperhidrosis is common and can be easy to treat. However, hyperhidrosis may be a manifestation of focal autonomic seizure resulting from life-threatening conditions such as glioblastoma. Clinicians need to have a high index of suspicion when managing patients with excessive recurrent sweating.
多汗症很常见。病史、体格检查及简单的检查通常足以确诊。然而，多汗症可能由局灶性自主神经发作引起。诊断局灶性自主神经发作具有挑战性，误诊率很高。
一名59岁的阿联酋男性出现持续3周的间歇性出汗发作和疲劳症状。初步鉴别诊断包括控制不佳的糖尿病、甲状腺功能亢进和心律失常。在就诊于五个不同专科后，怀疑为局灶性自主神经发作。磁共振成像扫描确诊为颞叶胶质母细胞瘤。患者接受了肿瘤手术切除，经左乙拉西坦和地塞米松治疗后症状缓解。
多汗症很常见且易于治疗。然而，多汗症可能是胶质母细胞瘤等危及生命的疾病导致的局灶性自主神经发作的表现。临床医生在治疗反复多汗的患者时需保持高度怀疑。
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