Metabolic and endocrine changes in spinal cord injury: I. The nervous system before and after transection of the spinal cord.

This is the first article of a 4-part series which provides a comprehensive, concise review and analysis of the pertinent literature published over the last 25 years on the metabolic and endocrine consequences of spinal cord injury. This article begins with a brief overview of the physiology of the nervous system, and then reviews the metabolic changes associated with the motor paralysis which follows cervical spinal cord injury. Studies reviewed on SCI patients include investigations of body composition (lean mass, fat, creatinine, water, electrolytes), urine composition (creatinine, uric acid, fluid balance, electrolytes), and the blood flow and histochemistry of paralyzed muscles. Studies reviewed from animal models include investigations of the properties of muscle cells, membranes, somatic receptors, and the kinetics of electrolytes in paralyzed limbs, and how succinylcholine modified these properties and kinetics. Information from articles reviewed here is organized under the following headings: problems studied, methods of investigation and results, conclusions, summary of results, discrepancies, areas of needed research, and practical clinical implications. Highlights of pertinent data contained in the original articles are organized in tables to facilitate direct comparisons between similar studies and between data on healthy and spinal cord injured subjects.