Département médullaire, centre Calvé, fondation Hopale, 62600 Berck-sur-Mer, France.
Ann Phys Rehabil Med. 2010 Oct;53(8):520-32. doi: 10.1016/j.rehab.2010.06.006. Epub 2010 Aug 13.
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).
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).
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.
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.
提出一种全面的方法来评估脊髓损伤（SCI）患者自主神经损伤的严重程度，考虑到损伤的水平。讨论如何评估失去上位中枢控制的孤立性脊髓交感神经（交感完全性损伤）。
在 PubMed 上搜索了有关心血管（主要是冷加压试验、呼吸和姿势挑战）和汗腺（交感皮肤反应）测试的文章，这些测试已经被应用。根据三种提供典型自主反应的 SCI 类型（四肢瘫、T6 以下和 T10 以下截瘫），根据刺激部位（损伤上方或下方）分析这些评估的结果。
非侵入性心血管和汗腺测试可用于评估 SCI 患者的孤立性脊髓交感神经。在与交感神经损伤水平相关的情况下发现了典型反应。其定义将允许与 SCI 患者的躯体运动和感觉损伤水平进行比较，并为这些患者的分类提供额外的帮助。
对于研究脊髓交感神经通路的完整性，可能需要使用一种测试方法，在损伤上方和下方使用刺激的组合，评估心血管和汗腺通路。
