Sympathetic skin response in patients with cerebellar degeneration
T. Yokota, M. Hayashi, H. Tanabe and H. Tsukagoshi
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Japan.
Sudomotor function was studied based on sympathetic skin responses (SSRs)
in 87 patients with various types of cerebellar degeneration. Evaluations
of orthostatic hypotension and the R-R interval variation were also
performed in these patients. The respective incidences of SSR abnormality
and orthostatic hypotension were 44 (50.6%) of 87 and 39 (44.8%) of 87.
Fourteen percent of the patients with abnormal SSRs did not have
orthostatic hypotension, but 8% of the patients with normal SSRs did have
orthostatic hypotension. Sympathetic skin responses were abnormal in most
patients with Shy-Drager syndrome, sporadic olivopontocerebellar atrophy
(OPCA), and striatonigral degeneration, whereas SSRs were normal in
patients with familial OPCA, sporadic cerebellar atrophy, and familial
cerebellar atrophy. We demonstrated that SSR can be used to evaluate
sudomotor function in degenerative disorders of the central nervous system
as well as in peripheral neuropathies. The vasomotor and sudomotor
functions usually are both disturbed in patients with cerebellar
degeneration, and the SSR can detect autonomic dysfunction as sensitively
as does the head-up tilt test. We also concluded that sporadic OPCA differs
from familial OPCA in that it has a much higher incidence of autonomic
dysfunction and that degeneration of the cerebellar cortex did not affect
the autonomic regulation.
