The
selective vulnerability of the
Autonomic Nervous System
and the acquired neuronal supersensitivity
until the end: Transverse Myelopathy
The nervous system is integrated with the vascular,
endocrine and im- munesystem. For the body to respond properly to
pollutant exposure, these systems must be in balance. However, in some
cases of chemical and radio-sensitivity, the balance between these
systems becomes im- paired, and the autonomic (nervous) system itself
becomes the primary target organ for pollutant injury.
The hypothalamus is the highest vegetative (autonomic) center in the
brain and is the focal point in triggering the pollutant-driven
responses seen in the chemically and radio-sensitive patient. It also
has functional connections with the forebrain and brainstem. When the
hypothalamus is triggered by pollutants, it may stimulate the
sympathetic and/or the pa- rasympathetic nervous system, resulting in
extraordinarily varied symp- tomatology.
The key elements in the vulnerability and acquired neuronal supersen-
sitivity, however, are hypoxia, hypoglycemia and convulsion, caused by
toxic-induced loss of tolerance.
The cardio-vascular system has a rich autonomic nervous system (ANS)
supply. To understand early pollutant injury to this system, one must
also understand the anatomy of the autonomic as well as the neuro-en-
docrine system.
In the chemically resp. radio-sensitive individual, for example, one
path of response to pollutant stimuli may end in cerebral arterial
malfunction with headaches that then become generalized cerebral
arterial malfunc- tionwith short-term memory loss and and finally
extend to frank hemi- plegia. Another regional response might be
coronary spasm with resul- tant angina pectoris, while another might be
renal arterial spasm with changes in angiotensin and, thus, blood
pressure.
The nervous system response to noxious substances entering the body is
immediate, with reflex-like rapidity. This pollutant-triggered quick
respon- se is the clinical response in the maladapted chemically
sensitive indiviual with overt and florid symptoms and signs in
contrast to the adapted nor- mal who does not even perceive the
response.
Toxicant-induced injury to the nervous system of the respiratory tree
can occur in the brain and in the respiratory center as well as in the
spinal cord, anterior horn cells, peripheral nerves, and/or the
Autonomic System and neuro-endocrine receptors. Also vascular
dysfunction of the respiratory tree causes discomfort and dysfunction
in the individual. Medical misinterpretation leaves the affected
individual to proceed on a path that eventually may lead to
irreversible fixed-name disease; e.g. a true ischemic transverse
myelopaty (oedematous swelling of the cord) is a recognized
complication of a vasculopathy with proliferative changes involving
small blood vessels, or can occur as a result in mixed con- nective
tissue disease or, more commonly, in systemic lupus erythematosus.
Transverse myelopathy may be the first manifestation of lupus ery-
thematosus; the spinal cord is most vulnerableto damage in the event of
an exacerbation of the underlying disease ("endless backache"). The
spinal cord has remained, until recently, the Cinderella of the nervous
system, receiving relatively scanty attention.
Quintessenz neuer klinischer Erfahrungen aus Germany & USA
(Literatur beim Verfasser)
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