Hand sweating is a syndrome in which the hands sweat easily due to abnormally high sympathetic excitation, often accompanied by excessive sweating in the armpits and feet. Patients are usually prone to sweating, and if they experience emotional stress or a slight increase in ambient temperature, the sweating symptoms increase, and some even appear as visible sweat droplets that look like hand washing, often causing great distress to patients at work and school. Hand sweating usually begins in childhood or adolescence and becomes more pronounced between the ages of 18 and 30. Studies have shown that hand sweating is quite common among young people of Eastern ethnic groups, with approximately 3 in 1,000 young people suffering from this condition and 30 to 50% of hand sweating patients having a familial predisposition. Pathophysiology Most patients with hand sweating have two distinctive features of the thoracic sympathetic nerve structure: 1. The number of myelinated nerve fibers in the thoracic sympathetic nerve is increased, i.e., the number of preganglionic fibers is increased, because the preganglionic nerve fibers originate from the spinal cord center of the sympathetic nerve, so the sympathetic nerve center has increased control over sympathetic excitation, resulting in excessive sweating; 2. The thickness of myelin sheath is proportional to the nerve conduction velocity, which makes the sympathetic conduction velocity increase. Clinically, a few patients can sweat a lot on both hands within a very short period of time, which may be related to this. The main symptom in patients with hand sweating is excessive sweating on both palms since childhood, which may be accompanied by excessive sweating in the axillae and soles of the feet. In severe cases, sweat droplets can be seen on the hands, which are hand-washing-like, often staining wet paper and even affecting self-confidence and social intercourse. According to the different degrees of symptoms, hand sweating can be divided into three levels: 1, mild, hands moist; 2, moderate, hands sweating with sweat herpes; 3, severe, hands sweat droplets, hand washing-like. Treatment measures 1, internal treatment Oral sedatives or anticholinergic drugs, which have many side effects, the efficacy is not obvious and short. External use of astringents or antiperspirants, the effect is poor, and there are many relapses when the medication is stopped. 2, botulinum toxin A blocking treatment subcutaneous injection of botulinum toxin A, very painful, need local anesthesia, some patients can still effect, but the validity is only 4-6 months, need to repeat the use, the toxin is expensive, pain heavy, not easy to promote. 3.Surgical treatment Thoracoscopic thoracic sympathectomy is a relatively popular and popular treatment method, with short operation time, simple and safe, reliable efficacy, small trauma and short hospital stay. Currently, most patients receive thoracoscopic thoracic sympathectomy for hand sweating with definite results. Note: Schematic diagram of minimally invasive thoracoscopic thoracic sympathectomy. Hand sweating disappears immediately about 2-5 minutes after cutting the thoracic sympathetic nerve during the operation.