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Shoulder-hand syndrome (SHS) is a frequent complication in stroke rehabilitation. Its etiology is not completely understood. We studied twenty-one hemiparetic patients with and eighteen patients without SHS. Variables were palm temperature, sympathetic skin responses (SSR), and proximal nerve latencies of both the affected and nonaffected upper extremity. In patients with SHS, the paretic extremity was significantly warmer and showed enhanced SSR responses when stimulated on the affected side and prolonged proximal nerve latencies in comparison to the nonaffected side. There was no difference in these parameters between both sides in patients without SHS. The altered tonic and reflex mediated sympathetic responses in patients with SHS may be related to neuroapraxia of the axillary plexus due to malalignment of the hemiplegic shoulder. Therapeutic consequences are discussed based on the pathomechanism. Key Words: Hemiparesis—Rehabilitation—Shoulder-hand syndrome.

neurorehabilitation and neural repair

Shoulder-Hand Syndrome in Hemiplegic Patients: Temperature, Sympathetic Skin Responses, and Nerve Latencies of the Affected and Nonaffected Upper Extremity