A Case of Heat Stroke with Presumed Spinal Cord Lesions
- VernacularTitle:脊髄病変が推定された熱中症の1例
- Author:
Akiko WATANABE
1
;
Aya SATO
1
;
Nanae HONGO
1
;
Mayuko TAOHATA
1
;
Takeshi SATO
1
Author Information
- Keywords: heat stroke; central nervous system sequelae; spinal cord lesions; nerve electrophysiology; peripheral neuropathy
- From:The Japanese Journal of Rehabilitation Medicine 2024;():23040-
- CountryJapan
- Language:Japanese
- Abstract: A 76-year-old woman was found unconscious in her home one morning in August. She was subsequently diagnosed and treated for heat stroke by her physician. However, 55 days later, she was transferred to our hospital presenting with symptoms of dementia, dysarthria, dysphagia, moderate bilateral upper extremity paralysis, severe lower extremity paraplegia, and loss of deep tendon reflexes. Cerebellar ataxia in her upper extremities and no sensory disturbance in her extremities were also noted. She required assistance when eating and upon excretion, as well as the use of a wheelchair. She was rehabilitated for one month and was subsequently able to urinate on her own. However, her physical function and ability to carry out daily activities did not improve. As a result, she was evaluated further using nerve conduction studies and needle electromyography, the results of which suggested spinal cord lesions (anterior horn cells or ventral roots). In 1985, Delgado et al. reported a case of central nervous system sequelae after heat stroke. In their case, flaccid quadriplegia, bladder-rectal disorder, and sweating dysfunction were observed, but no sensory disturbance was detected. They described pathological findings of lesions in the anterior horn, the medial lateral horn, and the ventral root of the spinal cord. Based on this, it is highly likely that spinal cord lesions were also caused by heat stroke in our case. Although there are few reports of spinal cord lesions as a sequela of heat stroke, this case highlights the need to carefully monitor patients of heat stroke for such pathological conditions.
