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Department of Neurology, Stroke Service (Drs. Labar, Mohr, and Tatemichi), Columbia-Presbyterian Medical Center, New York, NY, and the Department of Neurology (Dr. Nichols), Medical College of Georgia, Atlanta, GA.
Unilateral hyperhidrosis occurred contralateral to acute cerebral infarctions in six patients. Two patients had localized infarctions of opercular cortex, while the other four had large strokes involving both superficial cortical and deep subcortical structures. The unilateral hyperhidrosis typically involved the face and arm and was transient, lasting 1 to 3 days. No other autonomic dysfunction occurred. One patient died, and the others had significant residual neurologic disability, thus indicating poor prognosis when this sign is present. Disruption of a pathway of cortical origin, inhibitory to contralateral sweating, is a proposed mechanism for the hyperhidrosis seen contralateral to acute cerebral infarction in these patients.
Address correspondence and reprint requests to Dr. Labar, Department of Neurology, Division of Clinical Neurophysiology, The New York Hospital-Cornell Medical Center, 525 East 68th Street, New York, NY 10021.
Supported in part by contract NIH-NINCDS-N01-NS-5-2384, and Sunny von Bulow Coma and Head Trauma Research Foundation.
Presented in part at the thirty-seventh annual meeting of the American Academy of Neurology, Dallas, TX, April 1985.
Received February 9, 1988. Accepted for publication in final form May 16, 1988.
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