IN BULBAR poliomyelitis the hypothalamus shows evidence of microscopic damage in 85% of the cases. Clinical evidence of severe hypothalamic involvement in this disease is manifested by diverse symptomatology, including aberrations in temperature regulation, water metabolism, carbohydrate metabolism, cardiovascular control, and gastrointestinal activity. Since a large number of patients with bulbar poliomyelitis do have definite damage to the hypothalamic nuclei, one would expect many of the recovered patients to show some clinical evidence of such involvement. Unfortunately, there has been no single test or combination of tests which would enable one to adequately evaluate the status of this area of the nervous system. Adjustment to our constantly changing environment is effectively carried out by the hypothalamus under normal circumstances. Although invested with considerable reserve through its complicated connections, the hypothalamus when damaged is unable to control bodily responses adequately. Because of the importance of this regulatory center to the body economy and the high percentage of cases of poliomyelitis with damage to this area, clinical evaluation of this region seemed pertinent.In previous publications * a test battery was devised in an attempt to evaluate the hypothalamus through clinical and laboratory means. It was pointed out that in view of the complexity of this region, its connections, and multiplicity of func¬ tions no single test would be indicative of hypothalamic involvement. It was felt, however, that the abnormal responses to several tests in a battery of 10 or more, individually related to but not specific for hypothalamic function, would at least suggest involvement of a central regulatory center. Immediate criticism can be leveled at such an assumption in poliomyelitis, wherein the involvement is con¬ siderably more protean and involves widespread cerebral and cord damage with implication of sympathetic and parasympathetic fibers. The hypothalamus, how¬ ever, remains the coordinating center of this vast autonomie system and even if peripheral autonomie fibers are damaged, endocrine-hormonal equilibriums are maintained.

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