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(Stroke. 1995;26:1867-1870.)
© 1995 American Heart Association, Inc.

Articles

Prevalence and Associated Features of the Cold Hemiplegic Arm

Peter Wanklyn, MRCP; Anne Forster, PhD; John Young, FRCP Graham Mulley, DM

From the Departments of Medicine at Leeds General Infirmary (P.W.); St Luke's Hospital (A.F., J.Y.), Bradford; and the Department of Medicine for the Elderly, St James' University Hospital (G.M.), Leeds, UK.

Correspondence to Professor G.P. Mulley, Department of Medicine for the Elderly, St James' University Hospital, Beckett St, Leeds LS9 7TF, UK.

Background and Purpose Some stroke patients complain of an unpleasant sensation of coldness in the hemiplegic arm. This study aimed to determine the prevalence of this symptom and any associated features.

Methods A questionnaire about symptoms in the arms was sent to patients at least 12 months after stroke. Reflex sympathetic dystrophy (RSD) was diagnosed if four typical symptoms were present in the arm.

Results One hundred patients were recruited and 75 complete replies received. The mean age of the patients was 74 years, and the mean time since the stroke was 19 months. Forty patients (53%) experienced unilateral coldness in the hemiplegic arm. In 14 this sensation was constant, and 10 rated the symptom as troublesome. The symptom developed at a median time of 1 month after stroke, but only 13 patients (32%) sought advice from a doctor. Sensory symptoms and arm and shoulder pain were common, but the only symptoms associated with coldness were numbness (P<.001) and color change (P<.05). Fifteen patients fulfilled the diagnostic criteria for RSD, 13 of whom had coldness only in the hemiplegic arm.

Conclusions A sensation of coldness in the hemiplegic arm is common and distressing. It is associated with numbness and color changes in the arm. Some cases are caused by RSD, but other patients have coldness that may be due to other causes such as a vasomotor abnormality.

Key Words: hemiplegia • temperature • vasomotor system

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