Sympathetic skin responses recorded from non-palmar and non-plantar skin sites: their role in the evaluation of thermal sweating

Electroencephalogr Clin Neurophysiol. 1998 Sep;108(5):482-9. doi: 10.1016/s0168-5597(98)00025-2.


Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenoleukodystrophy / diagnosis
  • Adrenoleukodystrophy / physiopathology
  • Adult
  • Aged
  • Autonomic Nervous System Diseases / diagnosis*
  • Autonomic Nervous System Diseases / physiopathology
  • Body Height
  • Electric Stimulation
  • Female
  • Galvanic Skin Response
  • Hand / innervation*
  • Hot Temperature
  • Humans
  • Magnetics
  • Male
  • Middle Aged
  • Reaction Time / physiology
  • Skin / innervation*
  • Sweating / physiology*
  • Sympathetic Nervous System / physiology*
  • Thromboangiitis Obliterans / diagnosis
  • Thromboangiitis Obliterans / physiopathology