Diaphoresis, or excessive sweating, can be a symptom of various conditions. Learn more about possible causes.
Key questions to keep in mind when obtaining a history in patients with generalized weakness include the following: (1) Is a spinal cord lesion a possibility? (2) Is the process purely motor or is sensation involved? (3) Is the patient at risk for sudden respiratory failure?
These symptoms include headache, visual disturbances, lethargy, restlessness, irritability, dysarthria, confusion, somnolence, stupor, coma, hypothermia, seizures, ...
Weakness of the laryngeal and glottic muscles can lead to impaired swallowing and aspiration of secretions. A wet, gurgled voice and pooled oropharyngeal secretions are the best clinical signs of significant dysphagia.
Early symptoms of weakness can be subtle. Ask about difficulty arising from a chair, climbing stairs, lifting packages, combing or brushing hair, or turning keys or doorknobs.
A syndrome of agitation, restlessness, diaphoresis, hyperthermia, hypertension, tachycardia, tachypnea, hypertonia, and extensor posturing is often seen following severe TBI. There have been a number of terms given to this syndrome over the years including dysautonomia, autonomic (sympathetic) storming, diencephalic seizures, or midbrain dysregulatory syndrome. Paroxysmal sympathetic hyperactivity (PSH) has been proposed as an all-encompassing term for the syndrome.186
Pheochromocytoma produces headache, palpitations, diaphoresis, and pallor in individuals of light complexion, and it is frequently marked by paroxysms of BP that are difficult to regulate , especially in the absence of α-adrenergic blocking therapy. Diagnosis depends on a high index of clinical suspicion, verified by elevated 24-hour urine catecholamines (norepinephrine >80 µg/24 hours and vanillylmandelic acid >5 mg/24 hours). Reports suggest major diagnostic utility for assays of plasma free metanephrines, particularly in familial syndromes, although the test is relatively new and is not universally available.40 Imaging of the abdomen or adrenal glands will usually localize the tumor before surgical treatment. If the results are negative, whole-body scintigraphic imaging using iodine-123–metaiodobenzylguanidine may locate unusual extra-abdominal tumors. Most masses are benign and respond well to surgical treatment. This diagnosis should be a strong consideration if resistant hypertension is encountered in patients who have multiple endocrine neoplasia or neurocutaneous syndromes, such as neurofibromatosis or von Hippel–Lindau disease. Chapter 10 offers a further discussion of pheochromocytoma and related diseases.
Hawthorn is used widely by physicians in Europe for treatment of hypertension, angina, arrhythmias, and congestive heart failure. Although it is considered a cardiovascular tonic, its blood pressure-lowering effect is mild. Herbalists who use hawthorn for hypertension usually combine it with dandelion leaf and valerian.