Related Experiment Videos
Painful sweating.
David S Goldstein1, Sandra Pechnik, Jeffrey Moak
1Clinical Neurocardiology Section, National Institute of Neurologic Disorders and Stroke, Building 10, Room 6N252, 10 Center Drive, MSC 1620, Bethesda, MD 20892-1620, USA. goldsteind@ninds.nih.gov
Neurology
|October 27, 2004
Summary
This case study explores facial pain and sweating triggered by taste or spontaneously. Findings suggest aberrant nerve regeneration activating cholinergic receptors, potentially explaining conditions like Frey syndrome.
Area of Science:
- Neurology
- Dermatology
- Pain Medicine
Background:
- Reports a unique case of spontaneous and gustatory facial pain and sweating.
- Investigates the neurological underpinnings of trigeminal nerve-related autonomic cephalalgias.
Observation:
- Patient experienced bilateral facial pain and sweating in ophthalmic and maxillary distributions, triggered by gustatory stimuli and occurring spontaneously.
- Symptoms began in adolescence following treatment for facial warts.
Findings:
- Edrophonium administration evoked pain and sweating; trimethaphan blockade eliminated these symptoms.
- Acetylcholine iontophoresis induced pain and sweating, while topical glycopyrrolate cream abolished episodes.
- Suggests muscarinic cholinergic receptor activation by aberrant nerve sprouting post-injury.
Implications:
- Proposes a mechanism for gustatory sweating (similar to Frey syndrome) and facial pain due to aberrant nerve regeneration.
- Highlights the role of cholinergic pathways in trigeminal autonomic cephalalgias.
- Suggests potential therapeutic targets for similar conditions.