Post-stroke hemiplegic limb cold sensation and sympathetic nervous regulation: A review

PurposeThis review aimed to compare the efficacy of various sympathetic nerve regulation techniques in the treatment of cold sensations or abnormal sweating in hemiplegic limbs following stroke, providing guidance for managing autonomic nervous system dysfunction in post-stroke patients.MethodsA comprehensive search of the PubMed and China National Knowledge Infrastructure databases was conducted using the keywords "cerebral infarction," "cerebral hemorrhage," "stroke," "stellate ganglion block," "sympathetic nerve block," "sympathetic neurolysis," and "radiofrequency sympathectomy." Relevant studies published in English on the use of sympathetic nerve regulation to treat cold sensations or abnormal sweating in hemiplegic limbs after stroke were selected and rigorously reviewed. The collected literature was then categorized based on content and reviewed along with experimental results and clinical case evidence.ResultsSympathetic nerve regulation significantly improves cold sensation and abnormal sweating in hemiplegic limbs by inhibiting sympathetic activity, reducing sympathetic tone, increasing collateral and peripheral circulation, and enhancing skin and muscle blood perfusion, thereby increasing limb temperature and improving patient quality of life.ConclusionComputed tomography-guided thoracic/lumbar sympathetic radiofrequency ablation has demonstrated significant and lasting efficacy, with minimal complications. Therefore, it is recommended for treating cold sensations or abnormal sweating in hemiplegic limbs post-stroke.