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Sweat testing to evaluate autonomic function

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Abstract

Sudomotor dysfunction is common in many subtypes of neuropathy but is one of the earliest detectable neurophysiologic abnormalities in distal small fiber neuropathy. Clinical assessments of sudomotor function include thermoregulatory sweat testing (TST), quantitative sudomotor axon reflex testing (QSART), silicone impressions, the sympathetic skin response (SSR), the acetylcholine sweat-spot test and quantitative direct and indirect axon reflex testing (QDIRT). These testing techniques, when used in combination, can detect and localize pre- and postganglionic lesions, can provide early diagnosis of sudomotor dysfunction and can monitor disease progression or disease recovery. In this article, we describe many of the common clinical tests available for evaluation of sudomotor function with focus on the testing methodology and limitations while providing concrete examples of test results.

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Authors and Affiliations

  1. Autonomic and Peripheral Nerve Laboratory, Dept. of Neurology, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Boston, MA, 02215, USA

    Ben M. W. Illigens MD & Christopher H. Gibbons MD, MMSc

Authors
  1. Ben M. W. Illigens MD
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  2. Christopher H. Gibbons MD, MMSc
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Correspondence to Christopher H. Gibbons MD, MMSc.

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Illigens, B.M.W., Gibbons, C.H. Sweat testing to evaluate autonomic function. Clin Auton Res 19, 79–87 (2009). https://doi.org/10.1007/s10286-008-0506-8

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  • DOI: https://doi.org/10.1007/s10286-008-0506-8

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