cell body reorganization in the spinal cord after sympathectomy

The amount of compensatory sweating depends on the patient, the damage that the white rami communicans incurs, and the amount of cell body reorganization in the spinal cord after surgery.
Other potential complications include inadequate resection of the ganglia, gustatory sweating, pneumothorax, cardiac dysfunction, post-operative pain, and finally Horner’s syndrome secondary to resection of the stellate ganglion.
www.ubcmj.com/pdf/ubcmj_2_1_2010_24-29.pdf

After severing the cervical sympathetic trunk, the cells of the cervical sympathetic ganglion undergo transneuronic degeneration
After severing the sympathetic trunk, the cells of its origin undergo complete disintegration within a year.

http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract

Tuesday, January 13, 2015

Sympathectomy reduces emotional, stress-induced sweating indicating that it affects the stress-response


"...for reasons that are not obvious, many patients with facial hyperhidrosis and hyperhidrosis of the feet will benefit from upper thoracic sympathectomy. " 

(The Journal of Pain, Vol 1, No 4 (Winter), 2000: pp 261-264)

"Bilateral upper thoracic sympathicolysis is followed by redistribution of body perspiration, with a clear decrease in the zones regulated by mental or emotional stimuli, and an increase in the areas regulated by environmental stimuli, though we are unable to establish the etiology of this redistribution." 

(Surg Endosc. 2007 Nov;21(11):2030-3. Epub 2007 Mar 13.) 


"Palmar hyperhidrosis of clinical severity is a hallmark physical sign of many anxiety disorders, including generalized anxiety disorder, panic disorder, posttraumatic stress disorder, and especially social phobia.4 These are increasingly well understood and highly treatable neurobiological conditions. They are mod- erately heritable hard-wired fear responses,5 and are linked to amygdalar and locus coeruleus hyper-reactivity during psycho- social stress.6,7 Anxiety disorders are known to be much more common among women. This is consistent with the finding of Krogstad et al. that among controls sweating was reported more often by men, while among the hyperhidrosis group sweating was reported more often among women."

"A surgical treatment for anxiety-triggered palmar hyperhidrosis is not unlike treating tearfulness in major depression by severing the nerves to the lacrimal glands. We have recently made a similar argument advocating a psychopharmacological, rather then a surgi- cal, first-line treatment for blushing.9" 
(Journal Compilation - 2006 British Association of Dermatologists - British Journal of Dermatology 2006, DOI: 10.1111/j.1365-2133.2006.07547.x)




Tuesday, January 6, 2015

"Surgical treatment of facial blushing requires careful patient selection. The effect is a normalization of the threshold to trigger facial blushing especially in social situations."


Clin Auton Res (2003) 13 [Suppl 1] : I/26 – I/30 

"So when the sympathetic nervous system is activated,

it alerts the hypothalamus, which alerts the pituitary gland, which tells the adrenal gland (atop your kidney) to make stress chemicals. Those chemicals travel through the bloodstream and affect your whole body. In your brain, they inflame the amygdala (increasing the intensity of sadness, fear, and anger) and block the hippocampus from laying down memory tracks.
If these chemicals continue for any length of time, the hippocampus shrinks and the amygdala enlarges. You can see these changes on an MRI brain scan. Parts of the cortex (the gray area on the outside that does most of your thinking) are also affected, including the VMPF (ventral medial prefrontal cortex), which controls emotions by calming the amygdala. Other areas in our cortex that help us speak and think coherently also can decrease in size.
THE LONGER THE SYMPATHETIC NERVOUS SYSTEM STAYS ON, THE MORE DAMAGE IT CAN DO TO YOUR BRAIN."