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Unilateral Hyperhidrosis of the Chest, Face, and Arm.
Dr. Nicholas Wetzel and Dr. Sanford Larson.The case presented is that of a patient with increased sympathetic activity over the face, upper chest, and upper extremity on the left, with dissociated sensory loss in the same areas. The left upper extremity was also occasionally painful, although the pain was never the most troublesome symptom. The patient was most concerned with the excessive sweating. The symptoms appeared several years after an injury to the neck.Diagnostic studies, including spine films, electroencephalogram, and a myelogram, were normal.The autonomic symptoms were relieved by an upper thoracic sympathectomy, as was the pain, but some of the latter recurred after 6 months.The most probable site of the lesion is in the dorsal and intermediolateral cell columns of the lower cervical and upper thoracic spinal cord, without interruption of long ascending or descending tracts. The