Profuse unilateral hyperhidrosis induced by urinary retention in a stroke patient
Wang, J.-C.; Chan, R.-C.; Chang, P.-Y.; Yang, T.-F.
Neurologist 19(3): 82-84
ISSN/ISBN: 2331-2637 PMID: 25692515 DOI: 10.1097/nrl.0000000000000012
The diagnosis of urinary retention in stroke patients is challenging because their symptoms may be subtle, or go unnoticed. Furthermore, patients suffering from aphasia or impaired cognition often have difficulties communicating urination problems, leading to their urinary retention being overlooked. We report a 53-year-old man with bilateral pontine hemorrhage resulting in incomplete locked-in syndrome. During the patient's hospital course, he developed 3 episodes of rapid onset of profuse unilateral hyperhidrosis. All 3 episodes were found to be induced by an overly distended bladder and each time the unilateral hyperhidrosis resolved promptly after bladder drainage. This case provides the first description of unilateral hyperhidrosis as a manifestation of urinary retention in a stroke patient. It is important for clinicians to recognize this condition so that appropriate management can be implemented in time to prevent potential detrusor injury and renal impairment caused by bladder overdistension.