Neurological manifestations of accidental hypothermia

In a series of 97 patients with accidental hypothermia, alcohol abuse and Wernicke's encephalopathy were prominent causes. Pulse, systolic blood pressure, and respiratory rate were all found to decline with decreasing temperature, and there were significant changes (p less than 0.01) in level of consciousness, pupillary response, reflexes, and muscle tone. However, even in the lowest temperature range (20 degrees to 27 degrees C, or 68 degrees to 80 degrees F), 6 of 18 patients remained verbally responsive and 10 had intact reflexes. Neither eye movement abnormalities nor extensor plantar responses correlated directly with the degree of hypothermia.