POLIOMYELITIS: XII. Clinical Evaluation of Hypothalamic Involvement

IN BULBAR poliomyelitis the hypothalamus shows evidence of microscopic damage in 85% of the cases. Clinical evidence of severe hypothalamic involvement in this disease is manifested by diverse symptomatology, including aberrations in temperature regulation, water metabolism, carbohydrate metabolism, cardiovascular control, and gastrointestinal activity. Since a large number of patients with bulbar poliomyelitis do have definite damage to the hypothalamic nuclei, one would expect many of the recovered patients to show some clinical evidence of such involvement. Unfortunately, there has been no single test or combination of tests which would enable one to adequately evaluate the status of this area of the nervous system.Adjustment to our constantly changing environment is effectively carried out by the hypothalamus under normal circumstances. Although invested with considerable reserve through its complicated connections, the hypothalamus when damaged is unable to control bodily responses adequately. Because of the importance of this regulatory center to the body