Sweat function has been studied as part of the full neurological examination of 50 full-term infants with malformation of the central nervous system. 26 of the children were less than 1 month old at the time of examination, and a further 10 were less than 3 months old. In those infants in whom the response to thermal stimulation was equivocal, the local response to 20 μg intradermal acetylcholine was also studied. Sweat function was normal above the level of the spinal lesion in all of the 24 infants with a lumbar meningomyelocele, but there was virtually no response to thermal or chemical stimulation of the thigh in the 9 infants with a flaccid paralysis of the legs. In 8 infants born with gross disorganization of the basal ganglia or brainstem (as later confirmed by necropsy) there was no sweat response anywhere to either thermal or chemical stimulation. Similar generalized anhidrosis was found in 4 other infants with severe hydrocephalus.
These studies are consistent with the view that the eccrine sweat glands over most of the body only develop the ability to respond to acetylcholine if functionally innervated in utero. Sweat tests can provide information of prognostic value in full-term infants with defects of the CNS at birth.
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