Safety of Radiofrequency Ablation of Thoracic T2 and T3 Sympathectomy in Palmar Hyperhidrosis: A Case Report.

Hyperhidrosis Muscle Spasm Radiofrequency Sympathectomy

Journal

Anesthesiology and pain medicine
ISSN: 2228-7523
Titre abrégé: Anesth Pain Med
Pays: Netherlands
ID NLM: 101585412

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 13 04 2021
revised: 16 05 2021
accepted: 20 05 2021
entrez: 20 9 2021
pubmed: 21 9 2021
medline: 21 9 2021
Statut: epublish

Résumé

Hyperhidrosis is the maladjustment of excess sweating in specific parts of the body. Radiofrequency (RF) therapy has been successfully used to treat hyperhidrosis with a success rate of 85% - 95% in patients refractory to sympathectomy. The main hypothesis was the association between reduced palmar hyperhidrosis and radiofrequency RF therapy. The RF therapy is a less invasive technique, including the utilization of electromagnetic energy that is deposited near the nerve tissue. The mechanism of action of continuous RF could be explained by the destruction of afferent nerve fibers on their way from a nociceptive focus to the central nervous system. Pulsed RF was invented to explore this possibility, with the sole purpose of finding a less destructive and equally effective technique for the application of RF to afferent pathways. Herein, we further evaluated whether the procedure was safe without any complications in routine follow-up in palmar hyperhidrosis. Herein, we report the case of a male patient with an age of 22 years undergoing thermal RF sympathectomy therapy of thoracic T2 and T3 sympathetic ganglia for the palmar hyperhidrosis of his right hand observed for 3 months. The patient developed a contraction of the flexor involving the small muscles of the right hand with severe pain and congestion 17 days after the procedure without any other complications. The contraction was relieved by a sonar-guided median nerve block at the wrist with two injections of 2 mL lidocaine 2% and 2 mL dexamethasone. This study has been the first clinical case report complicated by the development of a contraction of the flexor muscles of the right hand with severe pain and congestion. The spasm was gradually relieved by sonar-guided median nerve injection at the level of the wrist and intended to assess the role of RF ablation with a success rate of 85% - 95% in palmar hyperhidrosis.

Identifiants

pubmed: 34540640
doi: 10.5812/aapm.114827
pmc: PMC8438739
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e114827

Informations de copyright

Copyright © 2021, Author(s).

Déclaration de conflit d'intérêts

Conflict of Interests: The authors declare that there is no conflict of interest.

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Auteurs

Atef Mohammad Khalil (A)

Fayoum University Hospital, Fayoum, Egypt.

Joseph Makram Botros (J)

Fayoum University Hospital, Fayoum, Egypt.

Maged Labib Boules (ML)

Fayoum University Hospital, Fayoum, Egypt.

Atef Kamel Salama (AK)

Kasralainy Hospital, Cairo University, Giza, Egypt.

Safaa Gaber Ragab (S)

Fayoum University Hospital, Fayoum, Egypt.

Classifications MeSH