DEPRESSION OF VIBRATORY SENSE LEVELS IN LUPUS ERYTHEMATOSUS

[摘要] Quantitative measurement of the vibratory sense is a simple, office procedure. Depression of levels of vibratory sense appreciation was observed in a large number of dermatologic and other diseases in the absence of neurologic pathology. Reduction of the pallesthetic sense is characteristic of lupus erythematosus in all of its manifestations. The avg. profile is 70% of normal in chronic discoid cases and 60% in disseminated cases. The profile is lower than other depressant diseases are present in the patient with this disease. The degree of depression is not exactly correlated with the severity of clinical manifestations. The causal relation between the reduction in vibratory sense discrimination and lupus erythematosus is clearly shown in three individuals in whom the pallesthetic profile was observed to be normal prior to the onset of lupus and was depressed following the onset of clinical symptoms of this disease. A change in the level of vibratory sense in a patient with lupus erythematosus is a good indicator of the activity of the morbid process. During involution, whether spontaneous or therapeutic, the level of this modality rises. Elevation of the vibratory profile is therefore a favorable prognostic sign. Elevations are to be expected as an end result of any successful therapy for lupus erythematosus, but occur more consistently and more rapidly following the intramusc. admn. of cyancobalamin. A reduction in the vibratory profile during treatment, or following the cessation of therapy, is evidence of recurrence or extension of the morbid process (if inherent toxicity of the therapeutic agent is ruled out) and may precede or accompany the clinical and laboratory changes. There is evidence that pallesthetically depressant diseases when occurring in the same patient act synergistically and produce a lower profile than either disease alone. When this occurs, normal vibratory profiles will rarely be achieved unless both diseases have been effectively treated.