Selective loss of cholinergic sudomotor fibers causes anhidrosis in Ross syndrome

Ann Neurol. 2002 Aug;52(2):247-50. doi: 10.1002/ana.10256.


Ross syndrome consists of segmental hyperhidrosis with widespread anhidrosis, Adie syndrome, and areflexia. The cause of this disorder is unknown. Selective degeneration of cholinergic fibers or of neural crest-derived structures has been suggested. We present clinical and skin biopsy data of 4 patients, providing evidence of reduced cholinergic sweat gland innervation in hypohidrotic skin by morphometric analysis. These findings indicate a selective degenerative process of the cholinergic sudomotor neurons.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biopsy
  • Cholinergic Fibers / pathology*
  • Female
  • Humans
  • Hyperhidrosis / complications*
  • Hypohidrosis / etiology*
  • Hypohidrosis / pathology
  • Male
  • Middle Aged
  • Pupil Disorders / complications*
  • Reflex, Abnormal*
  • Skin / pathology
  • Sweat Glands / innervation*
  • Syndrome