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

Saturday, November 14, 2009

low heart rate variability is associated with an increased risk for sudden cardiac death

The amount of short- and long-term variability in heart rate reflects the vagal and sympathetic function of the autonomic nervous system, respectively. Therefore heart rate variability can be used as a monitoring tool in clinical conditions with altered autonomic nervous system function. In postinfarction and diabetic patients, low heart rate variability is associated with an increased risk for sudden cardiac death. A sympathovagal imbalance is also detectable with heart rate variability analysis in coronary artery disease and essential hypertension.
http://www.annals.org/content/118/6/436.abstract
Posted by Mia at 5:04 AM

Thursday, November 12, 2009

Isointegral mapping revealed that ETS altered electroactivity on the heart

In the head-up tilt study, R–R intervals significantly increased after the surgery in the head-up tilt positions (P<0.05),> difference in the supine position. There is no significant difference in QTc and Twa before and after the surgery, both in the supine and the head-up tilt positions. There was no significant difference in the LF or HF before and after surgery, either in the supine position or the head-up tilt positions. In the LF/HF, there was no significant difference before and after surgery in the supine position. However, the LF/HF in the head-up tilt positions was significantly decreased after surgery (P<0.05).> suppression of ETS was recognized more obviously under the steeper head-up tilt positions. Conclusions: The influences on the cardiac autonomic nerve system of the ETS of upper thoracic sympathetic nerve were seen to be of a lesser degree at rest. However, the response to sympathetic stimulation was suppressed after the surgery.
Eur J Cardiothorac Surg 1999;15:194-198
Posted by Mia at 5:21 PM

Obviously, it is not simply a compensatory hyperhidrosis transposition

Obviously, it is not simply a compensatory hyperhidrosis transposition from postoperative reduction of palmar sweating. Based on our observations, we postulated two possible mechanisms. The first of these mechanisms is denervation hypersensitivity of the surgically injured distal sympathetic stump. This could explain why CH may appear soon after sympathectomy, but is not found in patients who undergo local excision of axillary sweat glands or undergo local treatment. Another mechanism is regeneration of preganglionic fibers or collateral sprouting of sympathetic fibers from the proximal stump of the sympathetic trunk. This could explain the long-term existence of PCH.

Ann Thorac Surg 2001;72:667-668
Posted by Mia at 5:12 PM

collateral effects of thoracic sympathectomy not disclosed to patients

Several reports also demonstrate significantly lower heart rate increases during exercise in subjects who have undergone bilateral ISS [9–12] compared to pre-surgical levels. In spite of this high occurrence, recent reviews on the usual collateral effects of thoracic sympathectomy still do not include these possible cardiac consequences [6].
Eur J Cardiothorac Surg 2001;20:1095-1100
Posted by Mia at 5:06 PM

similar to beta-blocker therapy

Findings on 123I-MIBG imaging studies indicate that EUTS (endoscopic upper thoracic sympathectomy) suppresses the activation of the sympathetic nervous system slightly, similar to beta-blocker therapy.
JNS - March 2004 Volume 100, Number 3
Posted by Mia at 4:14 PM
Introduction Essential hyperhidrosis (EH) is often considered to be related to an increased activity of sympathetic nervous system (SNS). However, there is a lack of studies comparing autonomic nervous system (ANS) activity in controls and in EH patients. The aim of the present study was to simultaneously investigate in patients with severe EH, blood pressure, heart rate variability and plasma catecholamine levels in comparison with controls.
Methods 19 EH patients and 20 controls with normal ANS function assessed by clinical testing were included. Blood pressure (BP) and heart rate (HR) were measured using a Finapres beat-to-beat monitor. BP and HR variabilities (Fast Fourier transformation) and plasma catecholamine levels (HPLC) were obtained at rest and during a 15 min 70° head-up tilt test.
Results At rest, a significantly higher relative energy of low frequency band (LF) of systolic BP was observed in EH in comparison with controls contrasting with the lack of difference in BP, HR, plasma catecholamine levels and in other spectral parameters. During tilt, all changes were comparable in EH and in control subjects excepting relative energy of LF of SBP which remained unchanged when compared to the resting condition in EH group.
Conclusions In EH, SNS is not overreactive even if resting overactivity cannot be excluded.
http://www.springerlink.com/content/xe7g2w72617phl0e/
Volume 13, Number 4 / August, 2003
Posted by Mia at 3:55 PM