Thermographic assessment of impaired sympathetic function in peripheral nerve injuries

Abstract

Twenty-three patients with focal, strictly unilateral lesions of the peripheral nervous system were examined by infrared-thermography. The Minor sweat test was used to determine if sympathetic outflow was disturbed. In fifteen patients without a concomitant sympathetic lesion (controls) thermosymmetry was not disturbed. Eight patients had evidence of abnormal sweat secretion. In these patients thermoregulation was severely disturbed. During the first 5 to 8 months, affected skin areas were hyperthermic, whereas later only hypothermia was observed. Cold stimuli increased temperature differences in patients with disturbed sympathetic function, but not in controls. Thermography is a reliable, non-invasive technique to detect a lesion of sympathetic outflow and permits an estimation of the time-course of the lesion.

Digital Rewarming Patterns After Median and Ulnar Nerve Injury

“…40,59 Our results showed that after a longer follow-up, return of active rewarming is possible. In several studies low digital blood flow did not correlate with subjective symptoms of CI.…”

“…During the first 6 months after nerve repair, they observed vasodilatation of the area supplied by the nerve at room temperature and after cold stress testing because of loss of sympathetic activity. 52,59 After approximately 6 months, compensatory changes provide vasoconstriction, and there is hypothermia at room temperature and after cold stress testing. 59 -61 To test an experimental setup using thermography as a temperature measurement device in nerveinjury patients with a more than 4-year-old nerve injury, we recently reported on a pilot study in 8 peripheral nerve injury patients.…”

“…11,15 In patients exposed to vibration tools (e.g., forestry workers, construction workers), Raynaud's disease, complex regional pain syndrome, or digital replantations and amputations, several laboratory tests have been used to study digital blood flow and skin temperature, for example, laser Doppler flowmetry, 31,40 -47 plethysmography to measure the amount of blood inflow, 27,34,43 finger systolic blood pressure, 26,33,48 -50 thermocouples on the skin, 4,44,45,51,52 and infrared thermography. 23,36,43,[53][54][55][56][57][58][59] However, to our knowledge, rewarming has been evaluated in nerve injury patients only by Ruch 40 in recent injuries (Ͻ3 months old) using laser Doppler flowmetry and thermocouples and by Pulst 59 in recent injuries (1-19 months) using infrared thermography at 7 and 15 minutes after immersion of the hands in ice water. During the first 6 months after nerve repair, they observed vasodilatation of the area supplied by the nerve at room temperature and after cold stress testing because of loss of sympathetic activity.…”

Plantar Infrared Thermography Measurements and Low Back Pain Intensity

“…Then, after the sympathetic denervation due to compression, a paralytic vasodilatation takes place, and finally, a vasoconstriction appears because of the postdenervation hypersensitivity of the blood vessels to circulating catecholamines. 18 In LBP, the thermal deficit was usually associated with chronic radiculopathy. 3,[5][6][7] The mechanism of those changes is not the direct compression of sympathetic fibers, but a sympathetic vasoconstriction reflex caused by an irritation of the dorsal nerve roots.…”

Temporal Changes in Skin Temperature Caused by Wet and Dry Heat in Healthy Volunteers

“…It is a noninvasive measurement that can generate an imaging record after computer processing in the form of contour lines that show high and low temperature regions. DITI can measure the temperature of any region of the body surface and can determine abnormal body temperatures as direct and indirect measurements 9,10) . Body temperature test regions measured by DITI can be compared with corresponding regions on healthy volunteers.…”