The prevalence of hyperhidrosis in patients with spinal cord injuries and an evaluation of the effect of dextropropoxyphene hydrochloride in therapy

The prevalence of annoying hyperhidrosis (HH) in patients with spinal cord traumatic lesions was investigated by a questionnaire. A total of 192 patients were sent the questionnaire, 154 patients answered, and 41 patients reported annoying sweating. Of these 41 patients, 13 had a somatic underlying cause and 28 indicated having annoying HH without a contributing somatic cause. Twenty-five patients with spinal cord injury (SCI) were included in a double-blind, randomized, placebo-controlled, crossover trial using dextropropoxyphene hydrochloride (DP) in a slow release form (Abalgin Retard 150 mg Benzon Pharma A/S, Copenhagen) twice a day, for the treatment of annoying HH. Nineteen patients with lesions between C4 and L4 completed the study. Eight found the active drug to be so effective that they wanted to continue the treatment while 3 preferred placebo. Six patients dropped out, 5 due to adverse effects. There was a trend towards an effect on sweating in daytime (p = 0.08-0.14). Given that the patients had a preference, which 15 of 19 had, the true frequency of patients preferring active treatment ranged from 32 to 84% (95% exact confidence limits). For those with SCI above T6 level the limits ranged from 40 to 97%. We conclude that in spite of the lack of statistically significant effect, it seems worthwhile to try DP for annoying HH, especially in patients with lesions above T6 level.