Oculosympathetic hyperactivity in idiopathic hyperhidrosis.

We describe a patient suffering from idiopathic hyperhidrosis, more pronounced on the right side, who presented with intermittent oculosympathetic hyperactivity (mydriasis, lid retraction and more rapid pupillary dilatation) on the same side. Mydriasis was induced by stress, loss of sleep and cold pressor test. The clinical features in this patient suggest an involvement of the hypothalamic structures.