Matsunaga K, Uozumi T, Tsuji S, Murai Y
Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu City, Fukuoka, Japan.
Electroencephalogr Clin Neurophysiol. 1998 Sep;108(5):482-9. doi: 10.1016/s0168-5597(98)00025-2.
To characterize the sympathetic skin responses (SSRs) recorded from non-palmar and non-plantar (non-Pa/P1) skin sites and to evaluate their clinical usefulness.
SSRs were recorded from 6 non-Pa/P1 sites as well as palmar and plantar (Pa/P1) sites using magnetic neck stimulation in 33 normal subjects, 17 neurological patients with dysautonomia and one patient with lumbar sympathectomy. A conventional thermoregulatory sweat test (TST) was also carried out in 3 patients.
Clear and reproducible SSRs were obtained from all recording sites in all of the normal subjects when the skin temperatures of the subjects were maintained above 34 degrees C and the subjects drank 100-200 ml of hot water. The distribution of absent SSRs was closely correlated with that of anhidrosis or a sweating delay shown by the TST in the patients. Nine of the 17 neurological patients (53%) showed normal responses at Pa/P1 sites, and abnormal responses at non-Pa/P1 sites.
Recording SSRs from multiple skin sites including non-Pa/P1 sites after magnetic stimulation is more sensitive in detecting sudomotor dysfunction than is the conventional method of recording SSRs from only Pa/P1 sites. In addition, this new method is very useful for the objective clinical evaluation of thermal sweating.
对从非手掌和非足底（非Pa/P1）皮肤部位记录的交感神经皮肤反应（SSRs）进行特征描述，并评估其临床实用性。
在33名正常受试者、17名患有自主神经功能障碍的神经科患者和1名接受腰交感神经切除术的患者中，使用磁颈刺激从6个非Pa/P1部位以及手掌和足底（Pa/P1）部位记录SSRs。还对3名患者进行了传统的体温调节汗液试验（TST）。
当受试者的皮肤温度保持在34摄氏度以上且受试者饮用100 - 200毫升热水时，所有正常受试者的所有记录部位均获得清晰且可重复的SSRs。患者中无SSRs的分布与TST显示的无汗或出汗延迟的分布密切相关。17名神经科患者中有9名（53%）在Pa/P1部位显示正常反应，而在非Pa/P1部位显示异常反应。
磁刺激后从包括非Pa/P1部位在内的多个皮肤部位记录SSRs在检测汗腺功能障碍方面比仅从Pa/P1部位记录SSRs的传统方法更敏感。此外，这种新方法对于热出汗的客观临床评估非常有用。
