11-14-2003, 06:39 PM
Jess called tonight and said that today during his exercise at PW he started sweating in the arm pits, something that has never happened before. I take this as good since any improvement is good. My question is if there is movement and sensation improvement where does the ability to sweat in the armpits come in?
11-14-2003, 08:33 PM
I think that it is a good sign, that jesse is getting some sympathetic reinnervation of his T2 and possibly T3 dermatomes. But interpretation of sweating is a little tricky. Interpreting sweat gland responses is a little like interpreting muscle activity. As you know, muscle activity can either be voluntary or due to segmental reflexes. The same is true of sweating responses. The brainstem has temperature sensors and when it is hot, the brainstem sends signals down the spinal cord to tell different regions of the body to sweat. However, you can also evoke sweating by local heating of the skin. After spinal cord injury, the excitability of the local sympathetic reflexes may be variable and depends on a number of factors. Early after injury, local sympathetic reflexes below the injury may be suppressed. If there is autonomic dysreflexia, there may be abnormal increases of sweating.
On the other hand, if there is not much sweating in other parts of the body and there is sweating in the armpits, it would suggest that jesse is regaining some sympathetic control of his T2 and perhaps even T3 dermatome.