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Collateral Ganglia
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The sympathetic chain ganglia, also known as the sympathetic trunk ganglia or paravertebral ganglia, are a series of ganglia located bilaterally on either side of the spinal column. These ganglia serve as relay stations for the sympathetic nervous system. Preganglionic neurons originating in the spinal cord project their axons to the sympathetic chain ganglia. Within the ganglia, these preganglionic fibers synapse with postganglionic neurons.The postganglionic neurons of the sympathetic trunk...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Quantitative Autonomic Testing
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Anhidrosis in multiple system atrophy involves pre- and postganglionic sudomotor dysfunction.

Elizabeth A Coon1, Robert D Fealey1, David M Sletten1

  • 1Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.

Movement Disorders : Official Journal of the Movement Disorder Society
|November 19, 2016
PubMed
Summary
This summary is machine-generated.

Sudomotor dysfunction is common in multiple system atrophy (MSA), particularly in MSA-parkinsonism. Sweat loss patterns can be preganglionic or mixed, worsening over time.

Keywords:
ataxiaautonomicmultiple system atrophyparkinsonismα-synuclein

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Area of Science:

  • Neurology
  • Autonomic Nervous System Research
  • Clinical Neuroscience

Background:

  • Multiple system atrophy (MSA) is a neurodegenerative disorder.
  • Sudomotor dysfunction, affecting sweat production, is a known complication of MSA.
  • Characterizing this dysfunction is crucial for understanding disease progression.

Purpose of the Study:

  • To detail the extent, pattern, location, and progression of sudomotor dysfunction in MSA.
  • To compare these characteristics between MSA with parkinsonism (MSA-P) and MSA with cerebellar symptoms (MSA-C).

Main Methods:

  • Retrospective review of 232 MSA patients from Mayo Clinic (2005-2010).
  • Utilized postganglionic sudomotor testing and thermoregulatory sweat tests (TST).
  • Determined lesion site (preganglionic, postganglionic, mixed) based on test results.

Main Results:

  • 95% of patients had abnormal TST; 59% had abnormal initial postganglionic testing.
  • MSA-P patients showed more frequent TST abnormalities (98% vs 90%) and greater anhidrosis (57% vs 48%) than MSA-C.
  • Lesions were predominantly preganglionic (47%) or mixed (41%); anhidrosis increased 6.2% annually.

Conclusions:

  • Sudomotor dysfunction is nearly universal in MSA, more severe in MSA-P.
  • A preganglionic pattern of sweat loss is common, but mixed abnormalities occur.
  • Increasing postganglionic dysfunction over time suggests later involvement of nerve fibers or sweat glands.