Shoulder‐Hand Syndrome Following Hemiplegia

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Abstract
The shoulder-hand syndrome is a painful disability of the upper extremities due to sympathetic nerve disturbance seen most commonly after myocardial infarction, trauma and hemiplegia. It is thought that any violence to tissue sets up afferent stimuli which activate the internuncial pool in the cord creating a disturbance affecting the anterior and lateral horn cells which innervate the upper extremity. The clinical symptoms are pain, disability, color changes and later deformities and trophic changes. Treatment has generally been orthopedic and physiotherapeutic with some surgical sympathetic procedures. Homolateral stellate ganglion blocks afford relief of pain and improvement of disability in majority of cases.