View Full Version : Question for SCI Nurse: Night sweating
09-08-2001, 01:55 PM
I'm a C5-6 Quad (complete)four years post. I like many of the people here have had my share of the usual problems with bladder, bowel, blood pressure, skin etc. I have also had to deal with a whole list of unusual problems.
As time has gone on it seems I find my self adding to that list. I have had this problem of sweating below the level of my injury. I have grown used to trying to 'trouble shoot' these problems as they pop up but have been unable to do so with this problem.
When my wife helps me get up bed we discover that I have sweated through the bed pad and sheets. I have no bladder infection, no bowel problems, no skin problems. I experience no problems managing my bladder so I'm not sweating due to Dysreflexia at night. I no evidence that any of my medications (Baclofin, Nurontin, Oxybutynin, Promatine) have had any side effects like this. Its not because of heat either. I can not identify any other external or internal stimuli that I can attribute this to.
Also when I sweat it has a strong odor like ammonia. Actually it smells like my cat box :} It's like my body freaks out opens up my pours and I wake up in a swamp. I don't know if you have heard of any one else who has had similar problems or what thoughts you might have but I would be happy to hear them.
09-08-2001, 06:57 PM
Kevin: I have no specific idea as to what would be causing ammonia-smelling sweat below your level of injury. I am wondering if you have had a general physical lately, and if so was your kidney function, etc. all normal? You may want to run these symptoms quickly past your practitioner to make sure there is nothing that needs to be checked out. (jah)
09-08-2001, 08:09 PM
Not to butt in, but the other thing I would want to check on is that you do not have a descending syrinx. This can often be asymptommatic except for positional sweating (ie, only when you lie down). (KLD)
09-08-2001, 09:39 PM
Has been sweating a lot to below my injury when I lie in bed. And now that I kind of think about it, it's started getting worse when my spasms started getting worse. I do only sweat when I am laying down overnight. Could that have anything to do with my spasms getting worse. I guess I should talk about this in my post about spasms.
09-08-2001, 10:02 PM
Well, I sweat below injury level but I think only for lying down but I'll take advantage on this discussion to mention that I perceived stiil in hospital that I only sweat on the left side. My movements from t 3-4 level up are similar on both sides but sweating (forehead, chest) only happens on left side since SCI.
None of docs could exactly explain the reason why it happens.
Does anyone have an idea?
09-09-2001, 06:14 AM
rybread: KLD is correct - a syrnix can be a cause of sweating. Any increase in spasams, a loss of function or sensation are all red-flags for a neurological change that can be caused by a syrnix. Although there are other things can cause these symptoms, a syrnix must be ruled out if no obvious cause can be found.
To check for this you should see your provider sooner than later. (jah)
09-09-2001, 07:14 AM
I do not think that what you are experiencing is unusual. I have had the same problem before. My OT in rehab said that her husband(who has a sci) had the same problem, she tried to research it and found no real explanation as to why sci people sometimes sweat profusely below the level of the injury. This was years ago, maybe someone knows something new, but I have not heard anything.I am not saying not to have it checked out, just do not panic. It still happens to me occasionally, sometimes you can draw a line down my body with the pools of sweat. It really is unpredictable and seems to be unrelated to anything. Make sure that you stay hydrated. It is really easy for it to lead to a uti if you do not take in as much fluid as you are loosing.
09-09-2001, 11:02 AM
I wanted to thank you for all your help. I will keep looking for answers with the help of my Doc. I have to say I'm sorry that I don't know what a syrnix is, some all this is such a blur. Could you please explain it.
09-09-2001, 04:40 PM
Kevin: A syrnix is the short version of syringomyelia, which is a narrowing of the spinal cord canal. This tends to happen more frequently after a SCI, but can opccur in AB people as well. The danger with developing a syrnix is that it can compress the spinal cord, causing further injury and disability.
To get a more complete explaination, I used the search function on the upper right corner of this page, typed in syringomyelia, and found quite a few postings. I copied what I thought was the best explanation, done by Dr. Young below (he posted it Aug 16, 01 on the Cure Forum:
Syringomyelia is a common occurrence. It is estimated that as many as 15% of people develop an expanding syringomyelic cyst (syrinx) after spinal cord injury, sometimes occurring many years after injury. Many people develop cysts that do not expand and remain stable for years. The way you can tell they are expanding is from a history of neurological loss (sensory or motor), increasing pain, and comparison of the cyst size with previous magnetic resonance images. If there is a history of recent neurological loss and the presence of a cyst, surgery is indicated.
The current theory is that the syrinx results from adhesions of the spinal cord to the dura, obstructing the flow of cerebrospinal fluid (CSF). The CSF consequently is forced through the central canal in the spinal cord. However, the central canal is frequently obstructed at the injury site. Even when the central canal is not obstructed, the increased flow will frequently cause a cyst (much in the same way a river will expand its size when the flow increases).
In the past, the standard therapeutic approach was to place a catheter to shunt the fluid from the cyst. Although this approach will immediately collapse the cyst, the cyst almost invariably will reform within a year or two, requiring repeated surgeries in over 80% of the patients. About 7 years ago, Barth Green at the Miami Project proposed that simply removing the adhesions between the spinal cord and the dura, with care taken during the postoperative period to prevent re-adhesion, is sufficient to eliminate the cyst in most of the cases. He published a study about two years ago, indicating that he was successful in permanently eradicating the cysts in close to 80% of patients. This practice is now being adopted around the world.
Carl Kao will untether and remove adhesions, as well as place an omentum graft to prevent further adhesions. He has had a lot of experience with this operation. He also places a peripheral nerve graft into the cavity. Many neurosurgeons in the United States also treat this condition. As mentioned, Miami has a great deal of experience. Likewise, UCLA, the Barrows Neurological Institute, the University of Florida at Gainesville are well-known centers with much experience with the treatment of syrinxes.
The threat of the syrinx depends on the position of the cyst. If the cyst is in the cervical spinal cord and is expanding towards the brainstem, that is potentially life-threatening. In addition, a cyst in the cervical spinal cord would damage neurons that innervate the arms and hands, resulting in atrophy. A cyst that is expanding in the thoracic spinal cord may not be life-threatening but can make life quite miserable from increased pain. A cyst that is expanding in the lumbosacral spinal cord may damage neurons that innervate the legs and cause atrophy. Obviously, all these should be avoided and prevented as much as possible.
An expanding cyst associated with progressive loss of neurological function is indeed something to be concerned about and should be corrected as soon as possible. While there are several other therapies that have been used to treat cysts, only surgery has been shown to be effective to date. The surgery with the best results have been removal of scar tissues between the spinal cord and dura and then taking measures to prevent scarring from recurring. Occasionally (about 15-20% of the cases), a surgeon may find relatively little scarring between the spinal cord and the dura... in that case the surgeon typically will go ahead to shunt the cyst (place a catheter in and drain the fluid either into the cerebrospinal fluid or into the pleural cavity). Some surgeons will go ahead and do both removal of adhesions and placing a shunt in, just in case. Many surgeons use artificial dura or cadaveric dura (from another person) to repair the dura so that it has room and does not press against the spinal cord after the dura is closed. Some surgeons go to some lengths to put patients on rotabeds that will prevent the spinal cord from lying on any side of the dura for a period of time after surgery, to prevent readhesion.
I hope this helps. (jah)
09-11-2001, 12:30 AM
That's intersting Klabm,
When I get AD, I only sweat on the left side of my face eventhough I sweat on both sides of my body as well as below my level of injury.
12-01-2001, 08:02 PM
I associate ammonia smell with liver......don't know where I picked up that info but must have found it on the net.
12-01-2001, 10:57 PM
I rarely have AD because I am incomplete enough that I tend to feel most pain. And while I never soaked a sheet, about a year ago I had night sweats and a dry cough. Went to my primary care doc and his first question was could I have been exposed to tuberculosis. I doubted it although after Viet Nam my husband always needs the Xray to rule out a positive tine test. So off to Xray I went to rule that out. Doc suggested a humidifier and to check back in in 2 weeks if the cough didn't go away. It did..just a bit of a viral thingy. But if you use hired help and they weren't required to get a TB test before working with you I'd suggest a lung Xray. Like everyone says, it's not always due to your SCI and TB does cause sweats mainly at night.