Lack of temperature control in infants with abnormalities of central nervous system

The temperature control of 11 infants with severe abnormalities of the central nervous system has been investigated. 4 were normothermic and 7 poikilothermic. Necropsy of the latter showed that either the hypothalamus was absent or disorganized, or the long tracts through the brainstem were unidentifiable, or in one case interrupted by a cervical myelocele. The lateral horn cells, sympathetic nervous system, and brown fat appeared normal. Where the normal reflex responses to warm and cool stimuli were absent, direct stimulation of the effector organs was attempted. Noradrenaline both stimulated heat production and constricted the peripheral skin vessels. Surprisingly, local application of pilocarpine or acetyl choline failed to stimulate the sweat glands which appeared normal at necropsy.