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

Friday, June 20, 2008

Sympathectomy for the treatment of polymorphic ventricular tachycardia

Bilateral thoracoscopic cervical sympathectomy for the treatment of recurrent polymorphic ventricular tachycardia.


Turley AJ, Thambyrajah J, Harcombe AA.
Despite potassium and magnesium supplements, beta blockade, implantation of a single then dual chamber implantable cardioverter defibrillator (ICD), amiodarone, nicorandil, and mexiletine, the patient continued to experience arrhythmia storms, receiving more than 700 ICD discharges over seven months. She was ultimately treated successfully with bilateral thoracoscopic cervicothoracic sympathectomies. This is the first reported bilateral thoracoscopic treatment of a patient with LQTS and symptomatic life threatening ventricular tachyarrhythmias refractory to current pharmacological and pacing techniques.

Cardiothoracic Division, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK. andrew.turley@stees.nhs.uk

Heart. 2005 Jan;91(1):15-7.

http://www.ncbi.nlm.nih.gov/pubmed/15604323

London Arrhythmia Centre

Long QT syndrome is a genetic abnormality that can lead to VT and cardiac arrest. The diagnosis is usually made by a 12 lead ECG, but an exercise test may be required to identify those with latent long QT syndrome manifest as a lack of QT shortening during exercise. Beta-blockade remains the mainstay of treatment, especially in the type l and ll subtypes, but symptomatic patients despite beta-blockade may require defibrillator implantation or sympathectomy. Long QT type 3 patients are at particular risk as their first presentation may be sudden cardiac death, and prophylactic implantation of an ICD is recommended.
http://www.londonarrhythmiacentre.co.uk/diagnosis-ventricular-ventricular-tachycardia.html

Only for people with short life expectancy

Sympathectomy should be used only for patients
who have failed with every other form of therapy and when the patient has
a short life expectancy.
Chronic Pain: Reflex Sympathetic
Dystrophy Prevention and
Management
H. Hooshmand, M.D.

S for depression, anxiety

In 1946, Karnosh (a neuropsychiatrist at the Cleveland
Clinic), Gardner, and Stowell62reported the effects of tem-
porary cerebral sympathectomy accomplished by bilateral
stellate ganglion blocks on organic brain diseases and psy-
choses.60,61 This discovery occurred incidentally in January
1946 when a 38-year-old woman received bilateral stellate
blocks for cerebral embolus accompanied by hemiplegia
and Dejerine–Roussy syndrome. This led to the implemen-
tation of this procedure in a series of patients with cere-
bral vascular disease, brain atrophy, and Parkinson disease.
Most patients were enthusiastic about the improvement that
they claimed the procedure produced, although motion pic-
ture analysis revealed no improvement in motor function
and it was believed that this apparently impressive improve-
ment in mood was caused by the sympatholytic effects.
Karnosh and Gardner decided to try bilateral stellate gan-
glion procaine blocks in a small group of patients suffering
from depression and anxiety and in patients with known
schizophrenia. In three patients with depression, the tempo-
rary sympathetic block resulted in an improvement of af-
fect, a relative euphoria, transient relief from suicidal idea-
tion, and psychomotor retardation.
W. James Gardner: pioneer neurosurgeon and inventor
NARENDRANATHOO, M.D., PH.D., MARCR. MAYBERG, M.D., ANDGENEH. BARNETT, M.D.
Brain Tumor Institute and Department of Neurosurgery, Cleveland Clinic Foundation,
Cleveland, Ohio
J Neurosurg 100:965–973, 2004