[Autonomic dysfunction of central nervous system disorders].

Central nervous system disorders, such as cerebrovascular or spinal cord lesions often cause dysfunctions of the autonomic nervous system. In most cases of acute cerebrovascular accidents, blood pressure is transiently elevated. Some patients, especially with pontine or thalamic hemorrhage, suffer from extremely high fever. In patients with large lesions in the cerebral hemisphere or lesions in the brainstem, cardiopulmonary state may be affected. In spite of absence of acute myocardial infarction, electrocardiogram may show ST-T changes resembling acute myocardial infarction. Cheyne-Stokes respiration or sleep apnea can occur. Lesions in the medulla oblongata cause dysfunctions of automatic respiration. Patients with large cerebrovascular lesions in the unilateral hemisphere often show transient hyperhidrosis on the contralateral side. Prognosis of patients with these autonomic failures is poor. In patients with spinal shock, blood pressure and heart rate are reduced. In chronic stage, autonomic hyperreflexia, such as attacks of episodic hypertension can occur. Lesions in the high cervical cord often bring nonsymptomatic perforating gastric ulcer.