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Sympathetic Deficits Following Thalamotomy

Sympathetic Deficits Following Thalamotomy Abstract SYMPATHETIC deficits have been found in 15 patients who have undergone thalamotomy for dyskinesia. These deficits have consisted of ptosis, miosis, and hemianhydrosis on the side of the body ipsilateral to the lesion. Sympathetic defects associated with brainstem lesions are not uncommon in clinical experience, as in the Wallenberg syndrome seen with lesions of the lateral medullary region. Apparently the efferent sympathetic pathways course through the lateral area of the medulla as they descend. However, reports of sympathetic loss with lesions rostral to the pons are rare. Small lesions of the upper brainstem which can be accurately localized and which result in limited defect are uncommon indeed. The investigation of these patients provides new information concerning the location of sympathetic paths at mesencephalic-diencephalic levels in man. Materials and Methods All of the patients reported in this series were operated on at the Neurological Institute of New York between May References 1. Schaltenbrand, B., and Bailey, P. (eds.): Introduction to Stereotaxic Operations and Atlas of the Human Brain , New York: Grune & Stratton, 1959. 2. Housepian, E.M., and Pool, J.L.: Application of Stereotaxic Methods to Histochemical, Electronmicroscopic and Electrophysiological Studies of Human Subcortical Structures , Confin Neurol 22:171-177, 1962.Crossref 3. Housepian, E.M., and Purpura, D.P.: Electrophysiological Studies of Subcortical-cortical Relations in Man , Electroenceph Clin Neurophysiol 15:20-28, 1963.Crossref 4. Minor, V.: Eines neues Verfahren zu der klinischen Untersuchung der Schweissabsonderung , Deutsch Z Nervenheilk 101:302-308, 1927Crossref 5. List, C.F., and Peet, M.: Sweat Secretion in Man: I. Sweating Responses in Normal Persons , Arch Neurol Psychiat 39:1228-1237, 1938.Crossref 6. Jasper, H.J.: An Improved Clinical Dermometer , J Neurosurg 2:257, 1945.Crossref 7. Lowenstein, O., and Lowenfeld, I.E.: Electronic Pupillography: A New Method and Some Clinical Applications , Arch Ophthal 59:352-363 ( (March) ) 1958.Crossref 8. Ritchie, J.M.; Cohen, P.J.; and Dripps, R.D.: " Local Anesthetics ," in Goodman, L.S., and Gilman, A. (eds.): Pharmacological Basis of Therapeutics , ed 3, New York: The Macmillan Co., Publishers, 1965. 9. Hertting, G.; Axelrod, J.; and Whitby, L.G.: Effect of Drugs on the Uptake and Metabolism of H3 Norepinephrine , J Pharmacol Exp Ther 134:146-153, 1961. 10. Jaffe, N.S.: Localization of Lesions Causing Horner's Syndrome , Arch Ophthal 44:710-728, 1950.Crossref 11. Walsh, F.B.: Clinical Neuro-ophthalmology , ed 2, Baltimore: Williams and Wilkins Co., 1957. 12. Ingram, W.R.: " Central Autonomic Mechanisms ," Handbook of Physiology , section 1: Neurophysiology, vol 2, Washington, DC: American Physiological Society, 1960. 13. Karplus, J.P., and Kreidl, A.: Gehrin und sympathicus: Ein Sympathicuszentrum im Zwischenhirn , Arch Ges Physiol 135:401, 1910.Crossref 14. Ranson, S.W.; Kabat, H.; and Magoun, H.W.: Autonomic Responses to Electrical Stimulation of Hypothalamus, Preoptic Region and Septum , Arch Neurol Psychiat 33:467-477, 1935.Crossref 15. Wang, S.C., and Ranson, S.W.: Descending Pathways From the Hypothalamus to the Medulla and Spinal Cord: Observations on Blood Pressure and Bladder Responses , J Comp Neurol 71:457-572, 1939.Crossref 16. Birzis, L., and Hemingway, A.: Descending Brain Stem Connections Controlling Shivering in the Cat , J Neurophysiol 19:37-43, 1956. 17. Birzis, L., and Hemingway, A.: Shivering as a Result of Brain Stimulation , J Neurophysiol 20:91-99, 1957. 18. Hemingway, A.: Shivering , Physiol Rev 43:397-422, 1963. 19. Beattie, J.; Brow, G.R.; and Long, C.N.H.: Physiological and Anatomical Evidence for the Existence of Nerve Tracts Connecting the Hypothalamus With Spinal Sympathetic Centers , Proc Roy Soc Biol 106:253-275, 1930.Crossref 20. Magoun, H.: Descending Connections From the Hypothalamus , Res Publ Assoc Nerv Ment Dis 20:270-285, 1940. 21. Crosby, E.C., and Woodburne, R.T.: The Mammalian Midbrain and Isthmus Regions—Fiber Connections. C. Hypothalamotegmental Pathways , J Comp Neurol 94:1-32, 1951.Crossref 22. Enoch, D.M., and Kerr, W.L.: Hypothalamic Vasopressor and Vesicopressor Pathways: II. Anatomic Study of Their Course and Connections , Arch Neurol 16:307-321, 1967.Crossref 23. Stead, E.A., et al: Central Autonomic Paralysis , Arch Neurol Psychiat 48:92-107, 1942.Crossref 24. Garcin, R., et al: Hemiballismus, Etude Anatomo-clinique , Rev Neurol 81:964-968, 1949. 25. Houdart, R., et al: Resultats des coagulations sous-thalamiques dans la maladie de Parkinson (a propos de 50 cas) , Rev Neurol 112:521-529, 1965. 26. Garcin, R., and Kipfer, M.: Syndrome de Claude Bernard-Horner et troubles oculosympathétiques dans les lésions du thalamus optique. Etude experimentale et clinique: Contribution a l'étude des voies et des centres diencephaliques du sympathique oculaire et des inégalités pupillaires d'origine sympathique dans les lésions du systéme nerveux central , Rev Neurol 71:121-156, 1939. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Sympathetic Deficits Following Thalamotomy

Carmel, Peter W.
Archives of Neurology , Volume 18 (4) – Apr 1, 1968
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References (33)

Publisher
American Medical Association
Copyright
Copyright © 1968 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1968.00470340064006
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Abstract

Abstract SYMPATHETIC deficits have been found in 15 patients who have undergone thalamotomy for dyskinesia. These deficits have consisted of ptosis, miosis, and hemianhydrosis on the side of the body ipsilateral to the lesion. Sympathetic defects associated with brainstem lesions are not uncommon in clinical experience, as in the Wallenberg syndrome seen with lesions of the lateral medullary region. Apparently the efferent sympathetic pathways course through the lateral area of the medulla as they descend. However, reports of sympathetic loss with lesions rostral to the pons are rare. Small lesions of the upper brainstem which can be accurately localized and which result in limited defect are uncommon indeed. The investigation of these patients provides new information concerning the location of sympathetic paths at mesencephalic-diencephalic levels in man. Materials and Methods All of the patients reported in this series were operated on at the Neurological Institute of New York between May References 1. Schaltenbrand, B., and Bailey, P. (eds.): Introduction to Stereotaxic Operations and Atlas of the Human Brain , New York: Grune & Stratton, 1959. 2. Housepian, E.M., and Pool, J.L.: Application of Stereotaxic Methods to Histochemical, Electronmicroscopic and Electrophysiological Studies of Human Subcortical Structures , Confin Neurol 22:171-177, 1962.Crossref 3. Housepian, E.M., and Purpura, D.P.: Electrophysiological Studies of Subcortical-cortical Relations in Man , Electroenceph Clin Neurophysiol 15:20-28, 1963.Crossref 4. Minor, V.: Eines neues Verfahren zu der klinischen Untersuchung der Schweissabsonderung , Deutsch Z Nervenheilk 101:302-308, 1927Crossref 5. List, C.F., and Peet, M.: Sweat Secretion in Man: I. Sweating Responses in Normal Persons , Arch Neurol Psychiat 39:1228-1237, 1938.Crossref 6. Jasper, H.J.: An Improved Clinical Dermometer , J Neurosurg 2:257, 1945.Crossref 7. Lowenstein, O., and Lowenfeld, I.E.: Electronic Pupillography: A New Method and Some Clinical Applications , Arch Ophthal 59:352-363 ( (March) ) 1958.Crossref 8. Ritchie, J.M.; Cohen, P.J.; and Dripps, R.D.: " Local Anesthetics ," in Goodman, L.S., and Gilman, A. (eds.): Pharmacological Basis of Therapeutics , ed 3, New York: The Macmillan Co., Publishers, 1965. 9. Hertting, G.; Axelrod, J.; and Whitby, L.G.: Effect of Drugs on the Uptake and Metabolism of H3 Norepinephrine , J Pharmacol Exp Ther 134:146-153, 1961. 10. Jaffe, N.S.: Localization of Lesions Causing Horner's Syndrome , Arch Ophthal 44:710-728, 1950.Crossref 11. Walsh, F.B.: Clinical Neuro-ophthalmology , ed 2, Baltimore: Williams and Wilkins Co., 1957. 12. Ingram, W.R.: " Central Autonomic Mechanisms ," Handbook of Physiology , section 1: Neurophysiology, vol 2, Washington, DC: American Physiological Society, 1960. 13. Karplus, J.P., and Kreidl, A.: Gehrin und sympathicus: Ein Sympathicuszentrum im Zwischenhirn , Arch Ges Physiol 135:401, 1910.Crossref 14. Ranson, S.W.; Kabat, H.; and Magoun, H.W.: Autonomic Responses to Electrical Stimulation of Hypothalamus, Preoptic Region and Septum , Arch Neurol Psychiat 33:467-477, 1935.Crossref 15. Wang, S.C., and Ranson, S.W.: Descending Pathways From the Hypothalamus to the Medulla and Spinal Cord: Observations on Blood Pressure and Bladder Responses , J Comp Neurol 71:457-572, 1939.Crossref 16. Birzis, L., and Hemingway, A.: Descending Brain Stem Connections Controlling Shivering in the Cat , J Neurophysiol 19:37-43, 1956. 17. Birzis, L., and Hemingway, A.: Shivering as a Result of Brain Stimulation , J Neurophysiol 20:91-99, 1957. 18. Hemingway, A.: Shivering , Physiol Rev 43:397-422, 1963. 19. Beattie, J.; Brow, G.R.; and Long, C.N.H.: Physiological and Anatomical Evidence for the Existence of Nerve Tracts Connecting the Hypothalamus With Spinal Sympathetic Centers , Proc Roy Soc Biol 106:253-275, 1930.Crossref 20. Magoun, H.: Descending Connections From the Hypothalamus , Res Publ Assoc Nerv Ment Dis 20:270-285, 1940. 21. Crosby, E.C., and Woodburne, R.T.: The Mammalian Midbrain and Isthmus Regions—Fiber Connections. C. Hypothalamotegmental Pathways , J Comp Neurol 94:1-32, 1951.Crossref 22. Enoch, D.M., and Kerr, W.L.: Hypothalamic Vasopressor and Vesicopressor Pathways: II. Anatomic Study of Their Course and Connections , Arch Neurol 16:307-321, 1967.Crossref 23. Stead, E.A., et al: Central Autonomic Paralysis , Arch Neurol Psychiat 48:92-107, 1942.Crossref 24. Garcin, R., et al: Hemiballismus, Etude Anatomo-clinique , Rev Neurol 81:964-968, 1949. 25. Houdart, R., et al: Resultats des coagulations sous-thalamiques dans la maladie de Parkinson (a propos de 50 cas) , Rev Neurol 112:521-529, 1965. 26. Garcin, R., and Kipfer, M.: Syndrome de Claude Bernard-Horner et troubles oculosympathétiques dans les lésions du thalamus optique. Etude experimentale et clinique: Contribution a l'étude des voies et des centres diencephaliques du sympathique oculaire et des inégalités pupillaires d'origine sympathique dans les lésions du systéme nerveux central , Rev Neurol 71:121-156, 1939.

Journal

Archives of Neurology – American Medical Association

Published: Apr 1, 1968

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