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© 1991 American Academy of Neurology Sudomotor function in autonomic failureClinical Neuropharmacology Section (Drs. Baser and Polinsky), Clinical Neuroscience Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD; the Department of Neurology (Dr. Meer), "Carmel" Hospital, Haifa, Israel; and the Human Motor Control Section (Dr. Hallett), Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD. We measured sweat production to direct gland stimulation with intradermal methacholine in patients with autonomic failure and in normal subjects. The sympathetic skin response (SSR) to electrical stimulation was assessed in some of the same subjects. Patients with pure autonomic failure (PAF) and multiple system atrophy (MSA) produced significantly less sweat than controls. None of the patients manifested greater than normal sweat production. Impaired sweat gland function does not differentiate MSA and PAF. The SSR did not correlate with sweat response to methacholine. An SSR can occur in the absence of normal sweat gland function. The diminished production of sweat in response to intradermal methacholine in PAF suggests that human sweat glands do not develop chronic denervation supersensitivity. Intradermal methacholine is a simple method to assess sweat gland function. Address correspondence and reprint requests to Dr. Mark Hallett, Building 10, Room 5N226, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892. Received July 3, 1990. Accepted for publication in final form March 18, 1991.
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