Arnold's idiopathic neuralgia: Surgical treatment, exploration in the trigger point at the basis of the neck

Abstract

Our purpose was to determine the effects on acute radiation sickness of interrupting afferent neural pathways that converge upon the medullary vomiting center but which bypass the emetic chemoreceptor trigger zone in the area postrema. A comparison was made of the vomiting response and other signs of sickness in three groups of chronic cats surgically prepared as follows: high spinal cord section of the dorsal columns, subdiaphragmatic vagotomy, and the combination of procedures. Every cat was exposed over the whole body to 45 Gy 60Co γ-radiation which was effective in evoking emesis in 11 of 12 normal cats. Neither cordotomy alone (8 cats) nor vagotomy alone (2 cats) reliably blocked the vomiting response but they separately delayed its onset. On the other hand, the cordotomy prevented the loss of appetite and behavioral malaise that was invariably caused by the irradiation in normal cats. Finally, the combination of cordotomy and vagotomy protected all of 3 cats against the entire radiation syndrome. These cats then vomited appropriately in response to the injection of deslanoside which induces emesis through an action on the area postrema. Histological examination of the lower medulla revealed no damage of the area postrema resulting from the cordotomies. We conclude that acute radiation sickness in the cat is signaled through afferent neural pathways originating in the abdomen and that the area postrema does not participate in the causation of this syndrome.