It is well known that the SSR (sympathetic skin response) is to evaluate the function of sudomotor activity and Digital infrared thermal imaging (DITI) is to evaluate the function of vasomotor activity of the sympathetic nerve. To assess the sympathetic nerve impairment in the patients with peripheral neuropathy, the SSRs and DITIs were tested in 35 cases. Twenty-four (68.6%) patients were abnormal on SSR test and twenty-nine (82.9%) patients were abnormal on DITI test. In the relationship between DITI and SSR, 19 (54.3%) cases were abnormal and 1 case was normal finding in both of these two tests. And the remaining 25 (42.9%) patients were abnormal on only either one of both tests. Frequency of abnormal SSR and DITI findings were correlated with severity of axonal involvement in peripheral nerve lesion. The results of this study revealed DITI to be more sensitive test in assessing sympathetic dysfunction in peripheral neuropathy than the SSR. However DITI has very limited values in the patients with symmetrically involved peripheral neuropathy because thermal asymmetry is considered as abnormal on DITI. Therefore, in assessing the function of sympathetic nerve in peripheral neuropathy, combined tests of SSR and DITI are useful.
Adolescent ; Adult ; Aged ; Child ; Comparative Study ; Female ; Human ; Image Processing, Computer-Assisted ; Infrared Rays/diagnostic use ; Male ; Middle Age ; Peripheral Nervous System Diseases/*physiopathology ; Predictive Value of Tests ; Sensitivity and Specificity ; Skin/*innervation ; Sympathetic Nervous System/*physiopathology ; *Thermography/methods

This study examined the net changes in temperature at various regions of the lower extremities in an attempt to identify the regions demonstrating the most significant temperature changes following a lumbar sympathetic ganglion block (LSGB). Thermography was performed before and after the LSGB in 26 sympathetic nerve system disorder cases. The inspection points were the anterior and posterior surfaces of the thigh, the knee and leg, and the dorsal and plantar surfaces of the feet. The net increases in skin temperature following the LSGB (deltaT (net) ) at the plantar and dorsal surfaces of the feet, were 6.2 +/- 2.68 degrees C (mean +/- SD) and 3.9 +/- 1.89degrees C, respectively, which were higher than those observed in the other regions of the lower extremities (p < 0.05). The areas, in order of decreasing deltaT (net), are as follows: the plantar surface of the foot, the dorsal surface of the foot, the shin, the anterior surface of the knee, the calf, the posterior surface of the knee, the anterior surface of the thigh, and the posterior surface of the thigh. There was one case of orthostatic hypotension during the thermography procedure. In conclusion, thermographic imaging is a useful method for demonstrating the success of a LSGB in various diseases. An evaluation of the deltaT (net) on the plantar surface of the feet using thermographic imaging is the most effective, simple, and safe method for assessing a successful LSGB.
Adult ; Aged ; *Autonomic Nerve Block ; Back Pain/surgery ; Body Temperature ; Complex Regional Pain Syndromes/physiopathology ; Female ; *Ganglia, Sympathetic ; Human ; Hyperhidrosis/physiopathology ; Infrared Rays/*diagnostic use ; Leg/physiopathology ; Lumbosacral Region ; Male ; Middle Aged ; Syndrome ; *Thermography ; Treatment Failure