Case Report
A Case of Traumatic High Thoracic Myelopathy Presenting Dissociated Impairment of Rostral Sympathetic Innervations and Isolated Segmental Sweating on Otherwise Anhidrotic Trunk
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HIROSHI SAITO, HIROAKI SAKUMA and KOJI SENO1
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Department of Neurology, and 1Department of Orthopaedics, Nishitaga National Hospital, Sendai 982-8555
A 3 year-old boy developed flaccid paraplegia, anesthesia below T3 and impaired vesical control immediately after a car accident. Three months later, the pupils and their pharmachological reactions were normal. Thermal sweating was markedly reduced on the right side of the face, neck, and shoulder and on the bilateral upper limbs, and was absent below T3 except for band like faint sweating on T7 sensory dermatome. The left side of the face, neck and shoulder showed compensatory hyperhidrosis. Facial skin temperature was higher on the sweating left side. Cervico-thoracic MRI suggested almost complete transection of the cord at the levels of T2 and T3 segments. We discussed the pathophysiology of the dissociated impairment of rostral sympathetic innervations and isolated segmental sweating on otherwise anhidrotic trunk.
Key words---
high thoracic myelopathy; rostral autonomic innervation; pupil; sweating
© 1999 Tohoku University Medical Press
Tohoku J. Exp. Med., 1999, 188, 95-102
Address for reprints:
Dr. Hiroshi Saito, Department of Neurology, Nishitaga National Hospital, 2-11-11 Kagitori-honcho, Taihaku-ku, Sendai 982-8555, Japan.
e-mail: hsaito@nisitaga.hosp.go.jp
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