Pain syndromes in the cervicobrachial region may be an expression of irritation of the periarterial autonomic nervous system. They show a vasal, arterial topography (here of the subclavian artery). If the cervical sympathetic chain is involved in the irritation, the area supplied by the carotid artery, i.e. the homolateral half of the head is also affected. Characteristics of these disturbances are their abnormal topography, which cannot be classified either as a radicular nor a segmental pattern. In this region the perception of pain is delayed. The quality of pain is protopathic (dull, intense, burning). In the sympathalgia region there is lowering of the pain threshold (dysesthesia), vasomotor disturbance (dyskinesia) local homeostatic disorders (dyscrasia), in certain circumstances trophic disturbances (dystrophy) which are usually accompanied by marked depression (dysthymia).
1: MMW Munch Med Wochenschr. 1979 Sep 14;121(37):1167-72.
http://www.ncbi.nlm.nih.gov/pubmed/114792
"Sympathectomy is a technique about which we have limited knowledge, applied to disorders about which we have little understanding." Associate Professor Robert Boas, Faculty of Pain Medicine of the Australasian College of Anaesthetists and the Royal College of Anaesthetists, The Journal of Pain, Vol 1, No 4 (Winter), 2000: pp 258-260
Wednesday, June 25, 2008
Sympathalgia can last for years in some patients
In addition, sympathectomy can cause postsympathectomy pain called sympathalgia in up to 44% of patients undergoing this procedure....
The sympathalgia secondary to sympathectomy usually starts around the first 2 weeks of the surgical procedure. It is a dull and cramping pain and occasionally can be a sharp pain. Although it is temporary in some patients, in others it can persist for several months or years.
H. Hooshmand, M.D.
Chronic Pain, page 156
The sympathalgia secondary to sympathectomy usually starts around the first 2 weeks of the surgical procedure. It is a dull and cramping pain and occasionally can be a sharp pain. Although it is temporary in some patients, in others it can persist for several months or years.
H. Hooshmand, M.D.
Chronic Pain, page 156