Thermoregulation is a critical aspect of homeostasis in mammals, ensuring that body temperature remains within a narrow, optimal range. The neural system plays a pivotal role in this process, integrating various signals and orchestrating responses to maintain thermal balance. This review delivers into the mechanisms by which the neural system regulates body temperature, the central and peripheral components involved, and the implications of thermoregulatory dysfunction.
We report a case of a 75-year-old woman who was diagnosed with dermatomyositis presenting with isolated dysphagia. There were no obvious cranial nerve deficits with normal motor grade in all the limbs in neurological examinations, but a suspicious rash was observed in the anterior chest. The serum creatine kinase was 306 IU/L, and active myopathic changes in bilateral limb muscles were observed in the electromyography test. Muscle biopsy from vastus lateralis showed perivascular infiltration of mononuclear inflammatory cells, which was compatible with dermatomyositis. She had responded to oral prednisolone and azathioprine.
Neurolymphomatosis (NL) is characterized by the infiltration of malignant lymphoma cells into peripheral nerves, nerve roots, plexuses, or cranial nerves. This is a very rare complication of mantle-cell lymphoma. Diagnosing NL is made difficult by cerebrospinal fluid cytology and bone-marrow biopsy results often being negative. NL can appear as the only sign of recurrence in a patient with a previous diagnosis of lymphoma. Here we present two cases of NL in patients with mantle-cell lymphoma diagnosed by positron emission tomography with deoxy-fluoro-D-glucose integrated with computed tomography.
Kee Hong Park, Byoung Joon Kim, Sa-Yoon Kang, Sun-Young Oh, Eun Hee Sohn, Kyeong-jin Song, Jin-Hong Shin, Kyoung Hwa Kang, Eun Bin Cho, Heejeong Jeong, Hyung Lee, Hyun Ah Kim, Rock Bum Kim, Ki-Jong Park
Ann Clin Neurophysiol 2019;21(2):87-93. Published online July 31, 2019
Background The standardized autonomic function test has become widely available. However, there are no reference data for this test for the Korean population. This study explored reference data for sudomotor and cardiovagal function tests for the Korean population.
Methods The sweat volume by quantitative sudomotor axon reflex test, heart-rate response to deep breathing (HRdb), expiration:inspiration (E:I) ratio, and Valsalva ratio (VR) were measured in 297 healthy Korean volunteers aged from 20 to 69 years. Multivariate regression analysis was performed to evaluate the effects of age, sex, and body mass index on these variables. The 2.5th, 5th, 10th, 90th, 95th, and 97.5th percentile values were obtained for each investigation.
Results The sweat volume was higher in males than in females. The HRdb and E:I ratio were negatively correlated with age, and were higher in males than in females. The VR was negatively correlated with age, but it was not correlated with sex.
Conclusions This study has provided data on the reference ranges for sudomotor and cardiovagal function tests in healthy Korean adults.
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Anhidrosis refers to the condition in which the body does not respond appropriately to thermal stimuli by sweating. Sweating plays an important role in maintaining the body temperature, and its absence should not be overlooked since an elevated body temperature can cause various symptoms, even leading to death when uncontrolled. The various neurological disorders that can induce anhidrosis make a detailed neurological evaluation essential. The medication history of the patient should also be checked because anhidrosis can be caused by various drugs. The tests available for evaluating sweating include the quantitative sudomotor axon reflex sweat test, thermoregulatory sweat test, sympathetic skin response, and electrochemical skin conductance. Pathological findings can also be checked directly in a skin biopsy. This review discusses the differential diagnosis and evaluation of anhidrosis.
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Primary aldosteronism is one of the most common cause of secondary hypertension and can be accompanied with hypokalemia. Rhabdomyolysis with hypokalemia in primary aldosteronism has been rarely reported. We describe a patient of primary aldosteronism who presented with limb-girdle type weakness.
Recognition of weakness pattern is important for localization and differential diagnosis. Typical presentation of proximal weakness is difficulty in raising arm, rising from floor, or climbing stairs. Most of muscle diseases present with proximal weakness. Peripheral neuropathy, neuromuscular junction disorder, or anterior horn cell disease can also manifest proximal weakness. In this article, we will review clinical presentation and differential diagnosis of proximal weakness.
Cervical spondylotic amyotrophy is characterized by muscle weakness and atrophy confined to the upper extremities without sensory involvement. It is classified as proximal type and distal type according to the affected myotomes. It usually develops after middle- age and manifests a self-limiting course. Different diagnoses include motor neuron disease, Hirayama disease, and neuralgic amyotrophy. Conservative and surgical management are effective. Older age, longer disease duration, lower preoperative muscle power, and distal type are poor outcome factors.
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