요부 교감신경절차단 후 발생한 심한 보상성 다한증

Abstract

A healthy, 25-year old female patient with no medical history complained of excessive palmar, plantar, axillary, back, and thigh sweating due to stress or a high temperature. Her whole body hyperhidrosis was often disabling and embarrassing in daily life. Plantar hyperhidrosis interfered with her social activities, and accordingly, she was suggested to have a lumbar sympathetic ganglion block with alcohol. Right side ganglion block was performed without any problem at the 3rd and 4th lumbar vertebrae. After sympathetic block, right foot sweating stopped, but phantom sweating continued for a week, and an ache in the pelvic area and flushing of the right foot continued for more than 10 days. Thus a left side procedure was postponed, but all symptoms disappeared after 21 days and the chemical neurolytic block of left side was subsequently performed, and plantar hyperhidrosis was resolved. However, 2 days after completing the lumbar sympathetic block, excessive sweating occurred in the facial, axillary, and back regions with upper body flushing. Two months later, her whole body, excepting the lower extremity showed running sweat after a 10 minute walk on exertion. To reduce the sweating, aluminum chloride, and oral and topical glycopyrrolate were prescribed to no affects. She is currently waiting for the return of normal lumbar sympathetic ganglion function.