Muscle Nerve 1994 Dec;17(12):1456-60


Is heat hypoalgesia a useful parameter in quantitative thermal testing of

alcoholic polyneuropathy?


Hilz MJ, Claus D, Neundorfer B, Zimmermann P, Beric A.


Department of Neurology, New York University Medical Center, New York.


Detection of thermal hypoaesthesia, hyperalgesia, and paradoxical sensation

significantly contribute to the diagnosis of polyneuropathy (PNP). There is

controversy about the clinical usefulness of detected heat hypoalgesia. In 50

chronic alcoholic patients we compared the prevalence and diagnostic value of

heat hypoalgesia (HPT) to that of cold (CT) and warm (WT) hypoaesthesia using a

"Marstock" thermotest. Clinical examination revealed PNP in 56%, cold

hypoaesthesia was present in 62%, warm hypoaesthesia in 24%, paradoxical thermal

sensation in 10%, cold and heat hyperalgesia in 12%, and heat hypoalgesia in

22%. Only 1 patient (2%) presented with heat hypoalgesia but normal warm and

cold thresholds; he reported paradoxical thermal sensation and had PNP. One

patient suffered first degree burn injury from heat pain examination. Heat

hypoalgesia contributed least to the diagnosis of polyneuropathy (HPT versus CT:

P < 0.001). In patients with sensory loss, testing heat hypoalgesia bears some

risk of burn injury. In contrast to thermal hypoaesthesia and hyperalgesia, it

does not significantly enrich the diagnostic workup of alcoholic