Sympathectomy increases total body perspiration, not decreases it

Performing thoracoscopic T2-T3 sympathectomy for PPH affects the total body sweating response to heat.
http://www.ncbi.nlm.nih.gov/pubmed/11193740
Kopelman D, Assalia A, Ehrenreich M, Ben-Amnon Y, Bahous H, Hashmonai M.

Department of Surgery B, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.

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Permanent thermoregulatory Dysfunction after Sympathectomy

The autonomic dysfunction you see on this thermal image is not a result of the surgery gone wrong, this is the result of a ...successful operation; it is the inevitable consequence of cutting/clamping the sympathetic chain, independently of skill of the surgeon, experience of the surgeon, T2, or T3, T4, or method used. Once the communication is disrupted, (and it happens with the clamping as well), it will disable the body's thermoregulation and will cause malfunctioning of the sympathetic nervous system. This damage is permanent and irreversible. "Sympathectomy is analogous to the act of killing the messenger. The sympathetic nervous system has the critical job of properly controlling and preserving the circulation in different parts of the body, especially in the extremities. By paralyzing the system, the extremity will be more apt to have disturbance of circulation and is left unprotected from fluctuation in circulation. Sympathectomy is similar to permanently removing the central heat and air-conditioning system and never replacing it because of malfunction." H. Hooshamand, MD Neurological Associates, Pain Management Center, Vero Beach, Florida

For a small group of patients sympathectomy can have devastating effects

ETS is a very effective way to treat hyperhidrosis and FB in the vast majority of the cases, but a small group of patients have devastating effects. Unfortunately, we do not know who these patients are before we operate.

Dr. Giudiceandrea Alberto, general and vascular surgeon
http://sympathectomy.info/

Possible side effects, ranging from trivial to devastating, are of even greater importance with these more permanent procedures.

G D Schott Consultant neurologist
Interrupting the sympathetic outflow in causalgia and reflex sympathetic dystrophy - A futile procedure for many patients
The National Hospital for Neurology and Neurosurgery, London
1998;316;789-790 BMJ

Sympathectomy reduces DOPAMINE - Latent inhibition and creative drive

Dopamine in the mesolimbic pathway increases general arousal and goal directed behaviors and decreases latent inhibition; all three effects increase the creative drive of idea generation. This has led to a three-factor model of creativity involving the frontal lobes, the temporal lobes, and mesolimbic dopamine.^[34]

This calcification was observed in both feet of 93% of patients, who had
undergone bilateral operation. After unilateral sympathectomy the incidence of calcified arteries on the side of operation was significantly higher than that on the contralateral side (88% versus 18%, p less than 0.01). Although diabetic patients showed longer stretches of calcification than non-diabetic subjects, the difference was not significant in terms of incidence and length. Of 20 patients who had no evidence of calcinosis pre-operatively, 11 developed medial calcification after unilateral operation exclusively on the side of sympathectomy. In seven patients calcinosis was detected in both feet after
bilateral operation. In conclusion, sympathetic denervation is one of the causes of Monckeberg's sclerosis regardless of diabetes mellitus.
Diabetologia. 1983 May;24(5):347-50, PMID: 6873514 [PubMed - indexed for MEDLINE]
Goebel FD, Fuessl HS.

Some of these side-effects, as listed on the Swedish support group website:

Side effects of the elective surgery:
Severe compensatory sweating = disabling sweating
Decreased physical capacity
Reduced blood circulation
Stomach problems (constipation or diarrhea)
Impotence
Oversensitivity to stress
Oversensitivity to sounds
Oversensitivity to light
Muscle weakness ("lactic acid in the arms")
Cold hands and feet - denervation supersensitivity
Horners syndrome
Reduced pulse reaction - delay in heart rate and BP responses, dizziness
Shortness of breath
Pain in arms and back - due to nerve sprouting
Chronic fatigue, lack of energy - S affects adrenaline levels
Raynauds disease - denervation supersensitivity

and from research:

Autonomic dysfunction
Vascular disturbances
Calcification of arteries
Permanently disabled thermoregulation
blocked nose or watery discharge/dripping from nose
dry, inflamed eyes
Reduced physical capacity, even when going up a flight of stairs - HR and BP responses delayed
depression - ETS reduces NE and catecholamines, increases serotonin
mood-swings
Altered sympathetic tone, feeling sedated/detached - beta-blocker effect
Inability to experience/respond to strong emotions - S disrupts signals from the viscera
Reduces/eliminates fear
difficulty concentrating, foggyness, memory affected
lack of motivation/drive/cognitive function - reduction of small vessels in the anterior cingulate cortex, altered catecholamines
overheating due to disabled thermoregulation, even when extreme sweating present - fever in hot weather or with physical activity/brain overheating
difficulty falling asleep/getting up - S eliminates circadian rhythm
Destabilized heart rate, arrythmia, dropped beats, morphofunctional changes in the myocardium
Reduced heart rate = reduced alertness, reduced emotional responses, ('not feeling alive'), all affecting long term memory (encoding).
Suppressed or eliminated Baroreflex = MAP instability
Mean Arterial Pressure instability, reduced short-term haemodynamic variability ('not feeling alive')
Hair loss, loss of eyebrows, eyelashes - altered blood flow in the skin
Dehydrated skin on upper body, face, scalp, - dandruff, skin infections, reduced immune responses
Reduced antibody responses - altered immune system

Several publications/books interchange 'Sympathectomy' and 'Spinal Cord Injury' due to the similarity in presentation/ symptoms.

Sweating after sympathetic surgery is a reflex cycle between the sympathetic system and the anterior portion of the hypothalamus according to our investigations. Reflex sweating will not happen if hand sweating can be stopped without interrupting sympathetic tone to the human brain. (sic!)
Chien-Chih Lin, M.D., *Timo Telaranta, M. D.

Presentation at the 4th International Symposium on Sympathetic Surgery

ETS is a relatively safe and simple procedure. However the side effects are possibly devastating All physicians providing this service and all peoples preparing to undergo this treatment should know this well.
Min-Huei Hsu (10 January 2005)
http://www.cmaj.ca/cgi/eletters/172/1/69#1908

Cervical sympathectomy inhibits axonal transport of gonadotropin-releasing hormone during continuous exposure to light

Department of Anesthesiology, Fukushima Medical College, 1 Hikarigaoka, 960-12 Fukushima, Japan
http://www.springerlink.com/content/q261272138632p52/

GNRH secretion is pulsatile in all vertebrates, and is necessary for correct reproductive function. Thus, a single hormone, GNRH1, controls a complex process of follicular growth, ovulation, and corpus luteum maintenance in the female, and spermatogenesis in the male.
http://en.wikipedia.org/wiki/Gonadotropin-releasing_hormone

The severity and manifestations of autonomic hyperreflexia are affected by the level of the sympathectomy. With mid-thoracic lesions below the level of cardiac accelerator fibers, hypertension is accompanied by reflex bradycardia transmitted via cardiac accelerator fibers and the vagus. In patients whose sympathectomy is above the level of the thoracic cardiac accelerator fibers, tachycardia may occur because cardiac accelerator fibers become part of the efferent sympathetic activity rather than part of the central inhibitory input from the brain stem and hypothalamus. Arrythmias and occasional heart block may accompany changes in heart rate.
Clinical manifestations of autonomic hyperreflexia include vasodilation, decresed sympathetic activity, and increased vagal activity above the level of the lesion such as nasal congestion, flushing, headache, dyspnea, nausea, and visceral muscle contraction. Vasoconstriction and increased sympathetic activity below the level of the lesion cause vasoconstrictive pallor, sweating, piloerection, and somatic muscle fasciculation. Patients also develop hypertension with headache, blurred vision, myocardial infarction, andretinal, subarachnoid and cerebral hemorrhages that may lead to syncope, convulsion and death.
Handbook of Neuroanesthesia
page 343
By Philippa Newfield, James E. Cottrell

Sympathectomy has a beta-blocker effect on the healthy patient

Cardiovascular changes after bilateral upper dorsal sympathectomy.

Papa MZ, Bass A, Schneiderman J, Drori Y, Tucker E, Adar R.
"The effect of bilateral upper dorsal sympathectomy (UDS) on cardiac function was investigated in two groups of young healthy patients who underwent bilateral excision of T2 and T3 ganglia for palmar hyperhidrosis.
The mean pulse rate decreased significantly in patients after they underwent bilateral UDS.
Pulse rates taken at rest and after effort were significantly lower than those taken after operation, and the blood pressure response to exercise was blunted. ECG tracings showed a significant change in the electrical frontal plane axis and shortening of
the QTc interval. These changes were evident 30 days after operation and persisted for 2 years. In conclusion, bilateral UDS has no overt arrhythmogenic effect in the young, healthy heart and its beta-blocker-like effect persists for at least 2 years." (the time of the tests performed)

Beta blockers block the action of endogenous catecholamines (epinephrine (adrenaline) and norepinephrine (noradrenaline) in particular), on β-adrenergic receptors, part of the sympathetic nervous system which mediates the fight or flight response.

The increase in heart rate in response to HUT (head-up tilt) was significantly reduced after surgery in the ETS group (from 34 ± 18 to 14 ± 11 beats·min⁻¹). Orthostatic hypertension disappeared completely after ETS , whereas the prevalence of orthostatic hypotension increased significantly after ETS (from 3 of 11 to 9 of 11 patients). http://www.springerlink.com/content/dk8tq89wnhq4naqy/

Cardiac arrest - a major complication of bilateral sympathectomy

Thoracic sympathectomy has usually minimal consequences if unilateral, especially on the right side. For
bilateral procedures, a mean reduction of the heart rate of 12% was reported. Around 50% of patients have bradycardia in the following minutes of abilateral surgery and mean and diastolic blood pressures significantly reduced.
Since the sympathectomy will block the chronotropic response, a significant increase of the ejection volume is observed when the patient moves in the erect position from dorsal decubitus.
Interact Cardiovasc Thorac Surg. 2008 Nov 27. [Epub

Chronotropic incompetence, an attenuated heart rate response to exercise, is a predictor of all-cause mortality in healthy populations. This association may be independent of exercise-induced myocardial perfusion defects.
Impaired Chronotropic Response to Exercise Stress Testing as a Predictor of Mortality
Michael S. Lauer, MD; Gary S. Francis, MD; Peter M. Okin, MD; Fredric J. Pashkow, MD; Claire E. Snader, MS; Thomas H. Marwick, MD
JAMA. 1999;281:524-529.

The haemodynamic effect of thoracoscopic cardiac sympathectomy
Lim-Sim Lee, Chien-Chih Lin, Seok-Mun Ng, Chung-Fai Au
The haemodynamic response to cardiac sympathetic denervation corresponded to the efferent effect of beta-receptor blockade.

Volume 164 Issue S1, Pages 37 - 38, Published Online: 2 Dec 2003

http://www3.interscience.wiley.com/journal/106568649/abstract

After sympathectomy, BP is maintained at nearly normal levels mainly through activation of the renin angiotensin system.

Heart and Circulatory Physiology, Vol 259, Issue 5 1337-H1342, Copyright © 1990 by American Physiological Society

A patient with angina pectoris who had been successfully treated by thoracoscopic cardiac sympathectomy was scheduled to have scalp debridement under general anaesthesia for a scald burn. There were haemodynamic changes during and after the operation including anaesthetic induction, endotracheal intubation, maintenance, and early recovery period. The sympathetic denervated heart showed little chronotropic response to anaesthetic and surgical stimulation. On the contrary, the parasympathetic response was predominant. An episode of severe bradycardia occurred during endotracheal suctioning prior to extubation. The haemodynamic response to cardiac sympathetic denervation corresponded to the efferent effect of beta-receptor blockade.
http://www3.interscience.wiley.com/journal/106568649/abstract

Sympathectomy-induced alterations of immunity

Many studies have demonstrated that ablation of the sympathetic nervous system (SNS) alters subsequent immune responses. Researchers have presumed that the altered immune responses are predominantly the result of the peripheral phenomenon of denervation.
Activation of the CNS was determined by immunocytochemical visualization of Fos protein in brains from male C57BL/6 mice at 8, 24, and 48 h following denervation. A dramatic induction of Fos protein was found in the paraventricular nucleus (PVN) of the hypothalamus and other specific brain regions at 8 and 24 h compared to vehicle control mice. Dual-antigen labeling demonstrates that corticotrophin releasing factor (CRF)-containing neurons in the PVN are activated by chemical sympathectomy; however, neurons containing neurotransmitters which may modulate CRF neurons, such as vasopressin, tyrosine hydroxylase, and adrenocorticotropin, do not coexpress Fos. Our findings suggest an involvement of the CNS in sympathectomy-induced alterations of immunity.
Tracy A. Callahan, Jan A. Moynihan and Diane T. Piekut
Brain, Behavior, and Immunity
Volume 12, Issue 3, September 1998, Pages 230-241

Marked MAP instability following sympathectomy

In conclusion, the results of the present study suggest a major role for the sympathetic nervous system in the regulation of regional circulations, the loss of which in sympathectomized rats results in a marked instability of MAP (mean arterial pressure). The vasodilator component of MAP lability after sympathectomy does not appear to depend on an episodic release of NO synthesized by the L-arginine pathway.

Genetic Hypertension: Proceedings of the 7th International Symposium on SHR and Related Studies Held in Lyon (France), Ecole Normale Supérieure, October 28-30, 1991

By Jean Sassard

These results indicate that chronic surgical sympathectomy of the heart can be successfully accomplished in the rat and guinea pig. Such sympathectomy induces a postjunctional supersensitivity in guinea- pig right atria which is qualitatively and quantitatively similar to that described previously for chronic treatment with reserpine. Bilateral surgical sympathectomy provides a valuable tool for future investigations of the cellular basis of supersensitivity in the myocardium.

Volume 234, Issue 1, pp. 280-287, 07/01/1985
Copyright © 1985 by American Society for Pharmacology and Experimental Therapeutics

What is ETS or Sympathectomy?

If you do a quick search on google because you want to find a solution for your sweaty palms, or do not want to blush every time someone looks at you, you will be flooded by all the information from the surgeons offering this procedure. If you only read these and do not have a medical background, you might fall for their statements and think to yourself: well, isn't medical science wonderful?!
You make your booking with one of the surgeons who will charm you and soon you are being wheeled in for the surgery with the promise from the surgeon, that it will change your life. You don't even know how true that is, until you wake up.
Here you will find the other side of the sales pitch and some answers to just how your life will never be the same.

Are we paying a high price for surgical sympathectomy? - A systematic literature review of late complications.

Surgical sympathectomy, irrespective of approach, is accompanied by several potentially disabling complications. Detailed informed consent is recommended when surgical sympathectomy is contemplated.
J Pain. 2000 Winter;1(4):245-57.

Sympathectomy supressed baroreflex control of heart rate

Loss of Baroreflex = aberrant blood pressure

Reduced baroreflex sensitivity is associated with increased vascular calcification and arterial stiffness

The reduction in BRS and the resulting aberrant blood pressure response to the physiological stress and volume changes of HD may be important in the further understanding of the pathophysiology of the increased mortality in HD patients with vascular calcification.

Lindsay J. Chesterton1, Mhairi K. Sigrist1, Terence Bennett2, Maarten W. Taal1 and Christopher W. McIntyre

T2 results in complete sympathectomy

Removal of only the second dorsal sympathetic. ganglion is stated to result in as complete sympathectomy, in so far as central connections are concerned.
Annual Review of Physiology
Vol. 6: 365-390 (Volume publication date March 1944)
(doi:10.1146/annurev.ph.06.030144.002053)

Visceral Functions of the Nervous System

B A McSwiney

Sympathectomy can be considered a psychiatric surgery

ETS can alter many bodily functions, including sweating, heart rate, heart stroke volume, blood pressure, thyroid, baroreflex, lung volume, pupil dilation, skin temperature, goose bumps and other aspects of the autonomic nervous system. It can diminish the body's physical reaction to exercise and/or strong emotion, and thus is considered psychiatric surgery. In rare cases sexual function or digestion may be modified as well.
©2006 LVHyperhidrosis.com
Dr Nagy, Las Vegas

Prof. Justin Oakley in Morality and the Emotions:
"an emotion is a complex which involves dynamically related elements of cognition, desire and affectivity.

Circadian Rhythm eliminated by Sympathectomy

The abrupt increase and decrease in BP observed at the time when the lighting conditions are changed are eliminated by chemical sympathectomy

The disruption of the baroreflex selectively eliminatesthe circadian rhythm of BP, and the circadian rhythms of BP andHR are modulated by the autonomic nervous system in rats. The circadianrhythms of BP and HR are regulated by different mechanisms involvingthe autonomic nervous system.
(Circulation. 1997;96:1667-1674.)
© 1997 American Heart Association, Inc.

retarded adaptation of hemodynamics to a sudden start of exercise following sympathectomy

The exercise capacity and the increase of coronary and systemic hemodynamics under treadmill exercise were studied in 5 dogs, chemically sympathectomized with 6-hydroxy-dopamine.

Completeness of adrenergic denervation was verified by stimulation of the right stellate ganglion, by intravenous administration of tyramine, and by demonstration of supersensitivity to exogenous norepinephrine.

These dogs demonstrated a retarded adaptation of hemodynamics to a sudden start of exercise. A fall in mean arterial pressure below 45 mmHg within 10 to 15 sec lead to collapse.
steady state attainment of hemodynamic parameters was considerably delayed.

E. Bassenge¹, J. Holtz¹, W. v. Restorff¹ and K. Oversohl¹

Received: 18 April 1973

Denervation supersensitivity leads to Raynaud's Disease

$Denervation supersensitivity leads to Raynaud\$
Cannon and his colleagues showed in the 1930s that section and subsequent degeneration of the sympathetic nerves led to a marked supersensitivity of the sturcture to exogenous catecholamines. The increase in sensitivity ranged from 10-to 100-fold in different tissues, such as the spleen on section of the splenic nerves, or the nictitating membrane on section of the postganglionic cervical sympathetic nerve or the heart on removal of the stellate ganglion. In smooth muscle the increase in sensitivity is mostly explained by the associated loss of neuronal re-uptake of noradrenaline, with only a lesser role for the increase in receptor numbers. Mechanisms of Drug Action on the Nervous System by Ronald W. Ryall, Cambridge University Press, 1989

Changes in Electrophysiology following sympathectomy

Sympathectomised dogs presented significant increases in: basic sinus period, sino-atrial conduction time (SACT), AH and HV intervals of the His bundle electrogram, atrial functional (AFRP) and effective (AERP) refractory periods, atrio-ventricular node functional (AVNFRP) and effective (AVNERP) refractory periods, ventricular functional (VFRP) and effective (EVRP) refractory periods and atrial (AMAP) and ventricular (VMAP) monophasic action potential durations. Corrected sinus recovery time (CSRT) was not affected by chemical sympathectomy. Neither was the atrial ERP/MAP duration ratio. This new form of sympathectomy affects all the levels of the cardiac conduction system. Such results are in accordance with those obtained with surgical sympathectomy or the use of beta-blocking agents.

DIANE GODIN*, CLAUDE GUIMOND{dagger}, RÉGINALD A NADEAU{ddagger} and A ROBERT LEBLANC§

Cardiovascular Research 1982 16(9):524-529;
© 1982 by European Society of Cardiology

Cardiovascular collapse caused by carbon dioxide insufflation during sympathectomy

Carbon dioxide insufflation into the pleural space during one-lung anaesthesia for thoracoscopic surgery is used in some centres to improve surgical access, even though this practice has been associated with well-described cardiovascular compromise. The present report is of a 35-year-old woman undergoing thoracoscopic left dorsal sympathectomy for hyperhidrosis. During one-lung anaesthesia the insufflation of carbon dioxide into the non-ventilated hemithorax for approximately 60 seconds, using a pressure-limited gas inflow, was accompanied by profound bradycardia and hypotension that resolved promptly with the release of the gas.
Australian Society of Anaesthetists 2002

Sympathetic regulation of the cerebral circulation by the carotid chemoreceptor reflex

After bilateral cervical sympathectomy (n = 9), carotid chemoreceptor reflex stimulation induced significantly different (P less than 0.01) effects on cerebral blood flow, which rose by 42 +/- 8%, and cerebral vascular resistance, which did not change.
In "sham" dogs, the repeat response to carotid chemoreceptor stimulation also induced significantly different effects from those in dogs with sympathectomy. Thus, in the conscious dog, stimulation of the carotid chemoreceptor reflex elicits significant sympathetically mediated vasoconstriction in cerebral vessels.
Am J Physiol Heart Circ Physiol 238: H594-H598, 1980;

Effect of adrenalectomy or sympathectomy on spinal cord blood flow

We conclude that adrenalectomy near-totally ablates the hypothermia-associated increase in RSCBF (regional spinal cord blood flow) measured in intact rats and that abdominal sympathectomy totally ablates it. This evidence complements morphological evidence for adrenergic innervation of the spinal cord vasculature.

Heart and Circulatory Physiology, Vol 260, Issue 3 827-H831, Copyright © 1991 by American Physiological Society

A. Iwai, W. W. Monafo and S. G. Eliasson
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110.

Sympathectomy induced adrenal hypertropy

Journal of Hypertension. 17(7):933-940, July 1999.
Qiua, Jingxin 1; Nelsona, Sharon H. 1; Spethb, Robert C. 2; Wanga, Donna H. 1,3

Objective: Previous studies indicate that the adrenal gland plays a compensatory role in the maintenance of blood pressure in chemically sympathectomized rats. However, the mechanisms responsible for compensatory adrenal responses are poorly understood. This study examined the regulation of adrenal growth and type 1A, 1B, and type 2 angiotensin II (Ang II) receptor (AT1A, AT1B and AT2) expression in the adrenal gland induced by sympathectomy.

Definition of the sympathetic ganglionic chain, that is cut/clamped during surgery

sympathetic ganglionic chain

From: A Dictionary of Psychology | Date: 2001 | Author: ANDREW M. COLMAN

sympathetic ganglionic chain n. A string of ganglia running down each side of the spinal cord throughout most of its length, containing cell bodies of neurons that belong to the sympathetic nervous system and that project axons to muscles and glands, controlling the smooth muscles of the blood vessels, eyelids, hair follicles, sweat, tear, and salivary glands, respiratory organs, irises, and also the heart and other organs. Also called the chain ganglia or sympathetic trunk.[From Greek syn with + pathos suffering + ganglion a cystic tumour]

Severe Hyperhidrosis as a side effect of ETS surgery to treat Palmar Hyperhidrosis...

Another example of the thermoregulatory dysfunction. However the whole body Hyperhidrosis is much more difficult to live with or cover up, as it soaks through clothes within minutes. The true number of people having disabling full body HH after this surgery is unknown. Surgeons maintain that it is a minute percentage of people. However there are too many who request reversals due to this side-effect. In fact the controversial reversal surgeries have become a very profitable part of the ETS surgeries. There are surgoens who specialize in doing reversals only. ETS is often covered by health insurance. Reversals are not. Surgeons and medical professionals NOT involved with the surgery maintain that the damage to the sympathetic chain can not be repaired. This applies to the clamping method as well. In that case the clamps would have to be removed within 24 hours. Usually it takes longer for the full body Hyperhidrosis to appear.

Thermoregulatory Disfuction - Severe CS. One of many of the side-effects of the elective surgery.

Note sharp line on upper chest: upper part of shoulders, neck, head and arms: anhidrosis, the inability to sweat and dissipate heat. 40% of the body heat exits the body through the top of the head. This aspect of the thermoregulation is disabled. Below the line of the T2 cut: PATHOLOGICAL sweating that requires complete change of clothes several times during the day. Sweating is not limited to the chest but includes full body surface. Constant wet skin is vulnerable to various skin diseases. CS is not only thermoregulatory. It can be triggered by stress, even in cold/winter conditons! This is the result for a patient who underwent the elective cosmetic surgery - that is hailed a a gold standard for palmar HH treatment. And this is only one side-effect of the many that are the necessary consequence of disrupting the sympathetic chain, irrespective of the surgeon's expertise or experience in executing the procedure. Post ETS sweating can not be predicted. Sweating patterns prior to surgery is not an indication of the CS post surgery. There is no difference in gender or weight when it comes to CS.

Nerve regeneration aka nerve sprouting leads to abnormal nerve function and pathological conditions

Regenerating sympathetic fibers create connections with nociceptive C-fibres, causing abnormal, sympathetically maintained pain conditions. Clinical studies in humans support the idea that nociceptors develop catecholamine sensitivity after complete or partial nerve lesions.
Sympathectomy, denervation has been linked to the development of Reflex Regional Pain Syndrome.
The regeneration of the sympathetic fibers is also responsible for the abnormal sweating during eating or smelling (food). This reaction can be triggered by any taste or smell, including spicy or hot food, apples, anything sour, chocolate, sweets etc. For the post-sympathectomy patient the otherwise anhydriotic areas of the face, upper body and arms will react with abnormal sweating and chills to these flavors/smells. The condition is called Frey's Syndrome and is caused by abnormal connections/interactions between the salivary gland and the sprouting sympathetic fibers.

Immune response and sympathectomy

Bone remodeling and resorption

The results further support that a regional sympathectomy causes qualitative alterations in bone modeling and remodeling, leading to bone resorption.

Marta G. Ladizeskya, Rodolfo A. Cutrerab, Verónica Boggiob, Carlos Mautalena and Daniel P. Cardinalib, *
Received 27 May 1999;

Signals from the sympathetic nervous system regulate hematopoietic stem cell egress from bone marrow.

Katayama Y, Battista M, Kao WM, Hidalgo A, Peired AJ, Thomas SA, Frenette PS.

Department of Medicine, Immunobiology Center and Black Family Stem Cell Institute, Mount Sinai School of Medicine, New York, NY 10029, USA

Worth considering:

If you damage your sympathetic nerve/chain - let's say - in a car accident, it it treated as a 'damage' and the symptoms that necessarily follow: 'illness'. You will - if lucky - have a diagnosis - most likely dysautonomia, the same condition (with numberless symptoms) people with spinal cord injuries suffer from. The imbalance between the (now disabled) sympathetic and parasympathetic nervous system will be responsible for the body's malfunctioning - physically and emotionally. So how can the same, destructive, surgical procedure be called CURE for people with non-life threating conditions, such as facial blushing, palmar or axillary sweating? And how can doctors, well aware of the impact the surgery will have, offer the surgery? When did the wellbeing of the patient become an obsolete aim?
This truly defies reason.

Patients with hyperhidrosis of the palm or soles, who fail to respond to topical agents, deserve a trial of conservative therapy, botulinum toxin, or iontophoresis, before aggressive surgical techniques that carry with them the risk of lifelong troublesome side effects are offered.

Lewis P Stolman, MD, FACP, FRCP(C)

Department of Dermatology, New York University School of Medicine, New York, NY
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2344132

Sympathectomy - a stress response attenuation