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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Neurology
Satisfied Customers: 18651
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My 37 year old son suffered severe-profound hypoxic brain

Customer Question

My 37 year old son suffered severe-profound hypoxic brain damage at 8 months of age...along with all the devastating & degenerative problems that go along with brain injury , he has in the last 4-5 years had decrease in his core temperature.....until at present his normal axillary temp is 94.0 -96.6 (approximately) ...but at times his skin temperature ( from touch & redness) will obviously be elevated ... which is most times a precursor to an oncoming rise in his core temperature ...could this be due to eccelerated brain atrophy ...or ... a combination of neurological changes ...degeneration?
Submitted: 9 months ago.
Category: Neurology
Expert:  Dr. Mo replied 9 months ago.

Hi Dr. Mo here.

Please give me a moment to read this and reply.

Expert:  Dr. Mo replied 9 months ago.

It is quite common with decreased neurologic input from the brain for the muscles and the skin to have less tone.

Essentially this will show up as lower skin temperature though the temp in the core will still be in the 98 range.

Expert:  Dr. Mo replied 9 months ago.

It may not be worsening brain atrophy but simply the muscles degenerating with time, since they are getting less neuronal inputs.

This is common when there has been major brain injury as a child.

Our muscle tone determines our external temps, when they are exercises less they will have less heat production. We also lose muscle mass as we get older.

Expert:  Dr. Mo replied 9 months ago.

Have you noticed him losing more muscle mass or having less activity as well?

Customer: replied 9 months ago.
He has no voluntary movement...pretty severe spasticity and pronounced clonus ...I'm not sure you understood .... his core ( axillary ) temperature has gradually lowered ... from the normal ...around 98.6 ... to consistently being 94.2 to 96.4 ... if his core temp gets to 98.0 he has a low grade temperature with hot flushed skin ....sometimes obvious signs of illness ( respiratory usually) with increased spasticity & seizures. He is in a long term care facility... with the care he recieves deteriating along with his general health. I know poor care has added to his decline ...but his inevitable problems are something I have been sadly aware of. I am a retired RN ... & very involved parent ... The facility has a neurologist considered "on staff " who makes ..maybe visits to see the patients who are medically fragile.... twice a year....I know my son's condition is very involved ...& it's not easy to give a comfortable, knowledgeable answer....I think I need to somehow insist on a meeting with his neurologist ....
Customer: replied 9 months ago.
I am really not satisfied with the answer I have gotten
Expert:  Dr. Mo replied 9 months ago.

I am sorry, I will have another physician answer you. I will open the question up for others.

Expert:  Dr. D. Love replied 9 months ago.

Hello, this is Dr. Love, a different expert.

The skin changes that you have noticed that precede the elevation in axillary temperatures would not be directly due to accelerated brain deterioration. It is common for impaired temperature regulation to occur with ongoing brain degeneration, but the flushing of the skin is a reflexive cooling mechanism, so further impairment of temperature regulation would cause a loss of these changes. As neurologic function deteriorates, he may have shifts in his axillary temperature that would not be explained by an infection or other apparent cause, but it is not usually manifested as skin flushing or temperature changes that precede an axillary temperature elevation that is from an infection.

However, it certainly is true that worsening neurologic function increases his risk for a variety of infections, particularly respiratory infections, and increasing incidence of infections can cause the reflexive mechanism to occur more often or be more noticeable.