Botulinum toxin A for palmar hyperhidrosis: assessment with sympathetic skin responses evoked by train of stimuli

Abstract

Objective assessment of the effect of botulinum toxin A (BT) treatment in primary palmar hyperhidrosis (PH) is attempted by different methods. We decided to use for this purpose sympathetic skin responses evoked by train of stimuli (TSSR). Twenty patients with severe PH (five female, median age 24, range 18-36) were examined regularly over 3 months after receiving 50 UI BT in each palm. TSSR were recorded from the palms after sensory stimulation by a train of three supramaximal electric pulses 3 millisecond apart. Results were compared to longitudinally studied TSSR of 20 healthy sex- and age-matched control subjects. All hyperhidrosis patients reported excellent improvement. TSSR amplitudes decreased at week 1 (mean 54% range 48%-67%) and over the following months in a clinically significant trend (slope R=-.82, P<.0001). TSSR in controls changed insignificantly (±13% from the baseline). The difference between patients and controls was highly significant at any time point (P<.001). This study suggests that TSSR may help in assessment of treatments in PH. It confirms objectively the efficacy of BT in PH.

Retrospective analysis of the efficacy and duration of botulinum toxin A injections in 30 patients with palmar hyperhidrosis

“…Botulinum toxin injections for palmar hyperhidrosis have few side‐effects 12,18,19 . The main side‐effect is reduced hand strength, which occurs in 20–45% of patients 3,20,21 . This is often transient, lasting for a few weeks 3,7,16,22,23 .…”

“…12,18,19 The main side-effect is reduced hand strength, which occurs in 20-45% of patients. 3,20,21 This is often transient, lasting for a few weeks. 3,7,16,22,23 We had favourable results, with only 23% of our patients self-reporting weakness for a median of 2 weeks, and only one patient with transient impairment that limited their ability to unscrew bottle tops.…”