Evaluation of peripheral nerve, brain stem and autonomic effects with clinical, electrophysiological and pain scale in children and adults with systemic sclerosis

Scleroderma, is a disease characterized by involvement in the skin and internal organs. Although not very common, central and peripheral nervous system involvement can be made and can lead to various types of neuropathy. In our study, we aimed to determine the peripheral and central effects of scleroderma in children and adults, to scale neuropathic pain, to determine and compare the characteristics of all patient and control groups. For this purpose, we evaluated peripheral nerve conduction studies, sympathetic skin responses, blink reflex and 4 question pain questionnaire results. In our adult patients, it was observed that all sensorial results and median, ulnar and tibial motor results had low amplitude, long distal latencies and F response latencies were long and median, ulnar and tibial conduction velocities were slow (p <0.05). The median and ulnar sensory conduction velocities were significantly slower in the pediatric patient group than in the control group. In the blink reflex responses, in the adult patient group R1, R2 and R2k latencies were longer than the control group (p <0.05). When sympathetic skin responses were evaluated, there was no significant difference between the patient and the controls in both adult and child groups. There is a significant difference in the DN4 score in adult and patient groups. As a result, it was observed that peripheral nerve and blink reflex responses were significantly different in patients with systemic sclerosis compared to normal controls even in the asymptomatic period, and this difference was correlated with duration of disease.