Aylin AKÇALI, Pirbudak ÇÖÇELLİÜ Lütfiye, Özkan Gülşen TANRIVERDİ, M. Halit DEMİR, Kaya Berna UĞUR

Combination therapy with sympathetic ganglion blockade and amitriptyline in a hyperhidrosis case

Palmar hiperhidrozis, her yaşta görülebilen, ellerde aşırı terleme ile karekterli, insan yaşamını olumsuz etkileyen bir hastalıktır. Tedavisi genellikle zordur ve çeşitli yöntemler uygulanmaktadır. Tedavi seçenekleri olarak, topikal ve sistemik ajanlar, iyontoforezis, botilinum toksin enjeksiyonları, cerrahi, kimyasal ve radyofrekans ile yapılabilen sempatektomi sayılabilir. Bu makalede oral amitriptilin ile birlikte lokal anestezikle yapılan sempatik ganglion blokajı uygulanan bir palmar hiperhidrozis olgusu sunulmuş ve bu tekniğin etkili ve iyi tolere edilebilir olduğu kanısına varılmıştır.

Hiperhidrozis vakasında sempatik ganglion blokajı ve amitriptilin ile kombine tedavi

Palmar hyperhidrosis is a disease characterised with excessive sweating of the hands that can be seen in every decade and can have negative effects on quality of life.Treatment for palmar hyperhidrosis is not easy and several methods are used. Treatment options include topical and systemic agents, iontophoresis, botulinum toxin injections, surgery,and sympathectomy with chemicals or radiofrequency. In this article we presented a palmar hyperhidrosis case treated by oral amitriptyline and sympathetic ganglion blockade with a local anaesthetic implying that this technique is effective and tolerable.

PDF

___

l.Wali MA. Early experience with thoracoscopic sympathectomy for palmar hyperhidrosis. Ann Thorac Cardiovasc Surg. 2003;9:351-354.
2.Horma Babana H, Lucas A, Marin F, Duvauferrier R, Rolland Y. Evaluation of the efficacy of CT guided thoracic sympatholysis to treat palmar hyperhidrosis. J Radiol. 2004;85:21-24.
3.Champion RH. Disorders of sweat glands. In: Champion RH, Burton JL, Burns DA, Breathnach SM, eds. Textbook of Dermatology, 6th ed. Oxford. Blackwell Science. 1998:1985-2002.
4.Sato K, Kang WH, Saga K, Sato KT. Biology of sweat glands and their disorders. I. Normal sweat gland function. J Am Acad Dermatol. 1989;20:537-563.
5.Vadoud-Seyedi J. Treatment of plantar hyperhidrosis with botulinum toxin type A. Int J Dermatol. 2004;43:969-971.
6.Haider A, Solish N. Focal hyperhidrosis: diagnosis and management. CMAJ. 2005; 172:69-75.
7.Hashmonai M, Assalia A, Kopelman D. Thoracoscopic sympathectomy for palmar hyperhidrosis. Ablate or resect? Surg Endosc. 2001; 15: 435-441.
8.Wilkinson HA. Percutaneous radiofrequency upper thoracic sympathectomy. Neurosurgery. 1996;38:715-725.
9.Rauck R.Sympathetic Nerve Blocks: Nead, Neck and Trunk In:Raj PP ed. Practical Management of Pain. 3rd ed. Missouri: Mosby Inc. 2000;651-682.
10.Brown DL. Stellate Block. Brown DL, ed. Atlas of Regional Anesthesia, 2nd ed. Philadelphia: W.B. Saunders Company. 1999; 187-193.
ll.Karakurum G, Pirbudak L, Oner U, Gulec A, Karadasli H, Satana T. Sympathetic blockade and amitriptyline in the treatment of reflex sympathetic dystrophy. Int J Clin Pract. 2003;57:585-587.
12.Erdine S. Sympathetic blocks of the head and neck. Raj PP, Lou L, Erdine S, Staats PS, Waldman SD, Racz G, et al. (eds) interventional pain management image-guided procedures (2nd ed). Philadelphia, Saunders Elsevier, 2008;7:108-126.
13.Manusov EG, Nadeau MT. Hyperhidrosis: A Management Dilemma. J Fam Prac. 1989;28:412-415.
14.Swartling C, Naver H, Lindberg M. Botulinum A toxin improves life quality in severe primary focal hyperhidrosis. Eur 3 Neur. 2001;8:247-252.
15.Schnider P, Binder M, KittlerİH, Dirner P, Storkel D, Wolff K. A randomized, double-İDİind, placebo-controlled, trial of botulinum toxin for severe axillary hyperhidrosis. Br J Dermatol. 1999;140:677-680.
16. Herbst F, Plas EG, Fugger R, Fritsch A. Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limbs. A critical analysis and long-term results of 480 operations. Ann Surg. 1994;220:86-90.
17.Ergin A, Yegül MI. Can Radiofrequency Thermocoagulation of Thoracal Sympathetic Ganglion be Useful in Hyperhidrosis Treatment? (Presentation of Two Cases). Gulhane Medical Journal. 2006;48:48-49.
18.Aşık ZS, Orbey BC, Aşık İ. Sympathetic radiofrequency neurolysis for unilateral lumbar hyperhidrosis: a case report. Ağrı. 2008;20(3):37-9.