ASYMMETRIC SWEATING IN STROKE - A PROSPECTIVE QUANTITATIVE STUDY OF PATIENTS WITH HEMISPHERAL BRAIN INFARCTION

We performed a prospective study of sweating in 40 patients with hemis pheral brain infarction and 40 healthy controls to elucidate the clini cal significance and prognostic value of sweating dysfunction in conju nction with brain infarction. We measured hidrosis quantitatively at s ix sites on each side of the body before and after a heating stimulus in the acute phase, at 1 month, and at 6 months after infarction. Exce ssive evaporation on the paretic side when compared with the nonpareti c side was already found at baseline, but after the heating stimulus, this asymmetry reached statistical significance on the forehead, chest , forearm, and hand during the whole 6-month follow-up. Significant as ymmetry in sweating occurred in 29 of the 40 patients (73%) in the acu te phase of infarction, in 18 of 32 (56%) after 1 month, and in 28 of 33 (85%) after 6 months. Hyperhidrosis correlated with the severity of paresis and the presence of pyramidal tract signs. We conclude that s weating asymmetry seems to be an essential, long-lasting consequence o f autonomic failure occurring in the majority of patients with hemisph eral brain infarction.