Hemorajik Serebrovasküler Hastalık Sonrası Kontralateral Hiperhidrozis; Vaka Sunumu

Year 2024, Volume: 9 Issue: 2, 84 - 87, 16.08.2024

Serhat Efdal Özbek Havva Talay Çalış Fatma Gül Ülkü Demir

https://doi.org/10.55694/jamer.1402369

Abstract

Serebrovasküler hastalıklarda(SVH) görülebilen otonom sinir sistemi bozuklukları; frontoparietal kortikal alanlarda ve beyin sapında merkezi otonomik ağın hasar görmesine veya hipotalamustan mezensefalon, pons ve medulla yoluyla omuriliğe inen otonomik yolların bozulmasına bağlanır. Hiperhidrozis de bu bozukluklardan biridir ve uzun sürelidir. İki yıl önce 10 gün ara ile rekürren hemorajik SVH geçiren 70 yaşında erkek hastamızın, ikinci SVH sonrası MR ve BT görüntülemeleri hemoraji ile uyumlu izlenmiştir. Hastanın yaklaşık 9 aydır olan sağ üst ekstremite ve gövdede daha belirgin ve fazla miktarda olan özellikle de geceleri olan terlemesi mevcut. Sağ alt ektremite daha az terliyor, nemli oluyor, yüzde terleme olmuyor. Hastanın eşi tedavisiyle ilgileniyor, her gün çarşaf değiştirdiğini ve çok sık banyo yaptırmak zorunda kaldığını söylüyor. Antihipertansif, antidiyabetik, antiagregan (asetilsalisilik asit) tedavi alan hastaya terleme şikayeti için gabapentin başlanmıştır. ‘İlerlemiş kanser hastalarının yaşadığı şiddetli terleme tedavisinde gabapentin’ başlıklı çalışmada 9 hasta üzerinde gabapentinin terleme üzerine olumlu etkileri olmuştur. Biz de hastamızda gabapentin dozunu kademeli olarak 1200 mg a kadar arttırdık. Terlemede azalma olduğunu kaydettik. Terleme şikâyeti hastaların konforunu azalttığı gibi bakımını da zorlaştırmaktadır. Terleme semptomunun gerilemesi hastalar ve yakınları açısından bir semptom iyileşmesinden daha fazlasını ifade etmektedir.

Keywords

inme, hemoraji, hiperhidroz

CONTRALATERAL HYPERHYDROSIS AFTER HEMORRHAGIC CEREBROVASCULAR DISEASE; CASE REPORT

Abstract

Autonomic nervous system disorders that can be seen in cerebrovascular diseases (CVD); it is attributed to damage to the central autonomic network in the frontoparietal cortical areas and brain stem, or to disruption of the autonomic pathways descending from the hypothalamus to the spinal cord via the mesencephalon, pons and medulla. Hyperhidrosis is one of these disorders and is long-lasting. The MRI and CT scans of our 70-year-old male patient, who had recurrent hemorrhagic CVH 2 times with an interval 10 days were consistent with hemorrhage after the second CVH. The patient has been experiencing more pronounced and excessive sweating in the right upper extremity and trunk, especially at night, for approximately 9 months. The right lower extremity sweats less and becomes moist, and there is no sweating on the face. The patient's wife is interested in his treatment and says that she changes his sheets every day and has to take a bath very often. The patient, who was receiving antihypertensive, antidiabetic and antiplatelet (acetylsalicylic acid) treatment, was started on gabapentin for his complaint of sweating. In the study titled "Gabapentin in the treatment of severe sweating experienced by advanced cancer patients", gabapentin had positive effects on sweating in 9 patients. We gradually increased the gabapentin dose in our patient to 1200 mg. We noted a reduction in sweating. Sweating complaints not only reduce the comfort of patients but also make their care difficult. The regression of sweating symptoms means more than just symptom improvement for patients and their relatives.

Keywords

stroke, hemorrhage, hyperhidrosis

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