Quantitative sensory study on post-stroke shoulder-hand syndrome

doi:10.3321/j.issn:1673-8225.2004.04.006

Abstract：BACKGROUND: It is certain that patients with shoulder-hand syndrome (SHS) have a decline in sensation. However, questionnaire or clinical evaluation for sensory disorder is not accurate.OBJECTIVE: To explore the thermal and vibration sensations of post-stroke patientsby quantitative sensory testing(QST) in an attempt to assess the relationship between small nerve fibre function and SHS.DESIGN: A case-controlled study.SETTING AND SUBJECTS: Thirty cases of post-stroke paralysis were selected from outpatients and inpatients in the Third Xiangya Hospital of Central South University from 2000-06 to 2001-04.METHODS: Limit method was carried out to examine thermal, pain and vibration sensations of affected upper limbs of the matched control patients (control group, n = 15) and the patients with post-stroke shoulder-hand syndrome (SHS group, n = 15 ). Incidences of shoulder-hand syndrome in two groups were also compared.MAIN OUTCOME MEASURES: The incidence of sensory disorder, thermal, pain and vibration sensation.RESULTS: Incidence of sensations dysfunction in SHS group was 67 %,significantly higher than that in control group(27% , P ＜ 0. 05) . Lowered cold-threshold(26.73 +4.48 vs 29.89 + 1.57, P ＜ 0.05) and elevated warm-threshold(26.73 +4.48 vs 29.89 + 1.57, P ＜ 0.05) were found in both SHS group and control group without significant difference between them. Difference among cold-evoked pain, heat-evoked pain and vibration thresholds was found significantly( P ＜ 0.01 ) . Differences between cold evoked pain threshold and cold threshold, as well as heat-evoked pain threshold and warm threshold were significant( P ＜ 0.01 ).CONCLUSION: Incidence of disordered sensation function in post-stroke paralyzed patients with SHS increases significantly, which mostly presents by reduced thermal sensation and hyperalgesia. C and Aδ nerve fibre dysfunction may play an important role in the pathogenesis.