The influence of skin temperature on latency and amplitude of the sympathetic skin response in normal subjects.

The influence of skin temperature on latency and amplitude of the sympathetic skin response (SSR) was studied in 10 normal subjects. SSRs were elicited in all four limbs of each subject by electrical stimulation after cooling of the right arm and after cooling of the right hand only. At low skin temperature, the latency was prolonged and the amplitude decreased. Latency and amplitude were linearly correlated with skin temperature of the right arm. There were no changes in the left arm and the legs, which basically excludes involvement of central pathways in these response parameters. With regard to the skin temperature of the arm, a temperature correction factor of 0.088 s/degrees C was calculated for latency. With regard to the skin temperature of the hand, latency prolongation was significantly greater after cooling of the whole arm. This suggests that not only the neuroglandular junction, but also the postganglionic sympathetic C fibers were responsible for latency modifications. In contrast, amplitude was reduced similarly after cooling of the whole arm and the hand only, suggesting that mainly the neuroglandular junction is responsible for amplitude modifications. We conclude that skin temperature is a mandatory measurement in the study of the SSR.

Lyme borreliosis neuropathy. A case report.

Lyme borreliosis is responsible for a large variety of peripheral neurologic manifestations including axonal polyneuropathy, radiculopathy, and facial nerve palsy. The prevalence of the disease must draw our attention on the possible responsibility of Borrelia burgdorferi in the pathogenesis of such symptomatology. Electrophysiologic studies demonstrate a proximal and distal axonal involvement, whereas neuropathologic studies suggest that vasculitis might be one of the primary pathophysiologic mechanisms. Electromyography provides a useful diagnostic tool and an important measure of response to treatment. Although peripheral neuropathy usually improves, our case report confirms the fact that chronic neurologic manifestations may not consistently resolve with appropriate treatment.

Evaluation of somatic and autonomic small fibers neuropathy in diabetes.

The relationship between somatic and autonomic neuropathy was assessed in the feet of 30 diabetic patients. Somatic small fiber function was evaluated by the thermal threshold test for cold (A delta fibers) and warmth (C fibers). Telethermography and transcutaneous oxygen tension were used to investigate the autonomic control of peripheral circulation. Autonomic neuropathy caused the opening of arteriovenous anastomosis, which was revealed through an elevation of the feet's temperature and a low transcutaneous oxygen tension. The association of the opening of the arteriovenous anastomosis and the perturbation of the thermal threshold test established a relationship between the dysfunction of the autonomic and the somatic fibers.

Exploration of glottic function before and after injection of collagen for rehabilitation of the vocal cord.

After more than one year's use of injectable collagen for vocal and glottic rehabilitation, the subjective and objective results have been presented for a series of 18 patients, 17 of whom had paralysis of one vocal cord, while one patient had a post-traumatic atrophy of the left cord. The assessment is based on rigid and flexible fibroscopy, stroboscopy, the objective phonatory assessment with measurement of the phonatory quotient and mean flow rate, EMG of the vocal cords and frequential analysis of the voice. Apart from the improvement in the phonatory quotients and outputs after injection, the noteworthy results have been the persistence of flexibility and undulation in the cord injected, visible by stroboscopy, and also the reappearance of the fundamental and 2 or 3 first harmonics on frequential analysis of the voice. The mean follow-up was 6.5 months, with a maximum of 14 months and minimum of 1 month. At the medium term, injectable collagen would appear to be a worthwhile alternative to Teflon because of its simplicity of use, its very great tolerance and the quality of the functional results obtained.