Article

OBJECTIVES: To present a comprehensive approach to the assessment of the severity
of the autonomic lesion in spinal cord injury (SCI) patients, with regard to the
level of lesion. To discuss how to assess an isolated sympathetic spinal cord
that has lost supraspinal control (sympathetically complete lesion). METHOD: PubMed was searched for articles related to cardiovascular (mainly cold pressor
test, respiratory and postural challenges) and sudomotor (sympathetic skin
responses) tests that have been used. The results of these evaluations are
analysed with regard to the site of stimulation (above or below the lesion)
according to three types of SCI that offer typical autonomic reactions
(tetraplegics, paraplegics at T6 and at T10). RESULTS: Non-invasive
cardiovascular and sudomotor testing allows the assessment of the isolated
sympathetic spinal cord in SCI patients. Typical responses are found in relation
with the level of the sympathetic lesion. Its definition would allow comparison
with the somatic motor and sensory level of lesion of SCI patients and provide
additional aid to the classification of those patients.
CONCLUSION: For research
purposes on the integrity of the spinal sympathetic pathways, a battery of test
approach is probably needed, using a combination of stimuli above and below the
lesion, evaluating both cardiovascular and sudomotor pathways.
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Langue : ANGLAIS ; FRANCAIS