Serebrovasküler Olay Sonrası Hemipleji Gelişen Hastalarda Sempatik Deri Yanıtları
2 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi 1. Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara
3 Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Ankara, Türkiye
4 Department of Physical Medicine and Rehabilitation, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
Autonomic dysfunction after cerebrovascular accident is a serious cause of mortality and morbidity because of clinical problems and complications during rehabilitation. However, data regarding the central organisation of sympathetic pathway and pathophysiological mechanism is very limited. We evaluated sympathetic skin responses (SSR) of 50 patients with hemiplegia: 30 male, 20 female with mean age of 60.02±12.88 years and 20 healthy subjects with mean age of 56.05±5.15 years. Ipsilateral and contralateral SSR were recorded with stimulation of median nerve in both affected and unaffected sides in patients and in both upper extremities in healthy group. SSR was suppressed significantly in acute phase patients. In 4 of the 14 patient (28.6%) in acute phase and 2 of the 32 patient (5.6%) in late phase, SSR was absent. The response amplitudes were significantly decreased and the latencies prolonged in hemiplegic patients compared with healthy subjects. Our results suggest that sympathetic dysfunction in hemiplegic patients are partially inhibited especially in acute phases. In late phases availability of the SSR is increased. In conclusion, the SSR represents autonomic function tests potentially useful in rehabilitation setting.
Keywords : Sympathetic skin responses (SSR), autonomic dysfunction, stroke, cerebrovascular accident, hemiplegia