sympathectomy can relieve symptoms of angina

Surgical sympathectomy can relieve symptoms of angina in patients with refractory angina. However, in these high-risk patients this thoracic surgery may result in significant morbidity and mortality rates.

Clinical Investigations

American Heart Journal. 133(6):648-655, June 1997.
Gramling-Babb, Patricia MD; Miller, Michael J. MD; Reeves, Scott T. MD; Roy, Raymond C. MD; Zile, Michael R. MD
http://pt.wkhealth.com/pt/re/amhj/abstract.00000406-199706000-00007.htm;jsessionid=L6WWlJ0hBkQfdvQ9pgYwy1mHSyrL4pcGKTw5PvNGJSgDFD1j8L3V!1270838445!181195628!8091!-1

disturbed peripheral vascular and heart rate responses

Thoracic sympathectomy can result in reduced sweating and disturbed peripheral vascular and heart rate responses. Patients should be warned that these mechanisms may play a role in the development of exertional heat stroke.

Is Previous Thoracic Sympathectomy a Risk Factor for Exertional Heat Stroke?
http://www.ncbi.nlm.nih.gov/pubmed/17720429

Abnormal stress responses in patients with diseases affecting the sympathetic nervous system

Patients who lack baroreceptors have exaggerated blood pressure responses to stress. They have episodes of hypertension and hypotension that cause headaches and dizziness.

Patients with diseases of the sympathetic nervous system illustrate that everyday occurrences such as a change in posture or ambient temperature are stresses requiring a marked change in sympathetic nervous activity. Both physical and psychological stresses elicit large initial sympathetic neuronal responses that are subsequently damped by feedback inhibition from structures such as the baroreceptors. Damage to part of these feedback loops leads to exaggerated pressor responses to stress.
Ziegler MG, Ruiz-Ramon P, Shapiro MH.

University of California, San Diego.

Psychosom Med. 1993 Jul-Aug;55(4):339-46.

complex alterations of vascular reactivity

Enhanced vascular reactivity in the sympathectomized rat: studies in vivo and in small isolated resistance arteries.

Conclusions: In conclusion, we showed that sympathectomy produces complex alterations of vascular reactivity both in vivo and in isolated vessels, which shift the balance of the sensitivity of the vessel between vasoconstrictor and vasodilating agents towards an increased constriction. These results are unlikely to simply reflect denervation supersensitivity; their underlying receptor, post-receptor and/or contractile mechanisms are yet to be identified.

Journal of Hypertension. 18(8):1041-1049, August 2000.
Rizzoni, Damiano 1; Perlini, Stefano 2,3; Mircoli, Luca 2; Porteri, Enzo 1; Franzelli, Cristina 2; Castellano, Maurizio 1; Rosei, Enrico Agabiti 1; Ferrari, Alberto U. 2,4

Abnormal pain following nerve sprouting

Collectively, our findings indicate that as a result of autonomic sprouting due to CCI of the MN, remaining intact nociceptive fibres may potentially develop sensitivity to sympathetic and parasympathetic stimulation, which may have a role in the generation of abnormal pain following nerve injury.

---

Received 22 October 2004, revised 17 February 2005, accepted 23 February 2005

C. Grelik ¹ , G. J. Bennett ^3,4,5 and A. Ribeiro-da-Silva ^1,2,5

¹ Department of Pharmacology & Therapeutics, McGill University, 3655 Prom. Sir-William-Osler, Montreal, Quebec, Canada H3G 1Y6
² Department of Anatomy and Cell Biology,
³ Department of Anesthesia,
⁴ Faculty of Dentistry, and
⁵ McGill Centre for Research on Pain, McGill University, Montreal, Quebec, Canada

Summary from the University of Cambridge

ANDBN, MAGNUSSON and ROSENGREN (1965)
have demonstrated a complete loss of DOPA decarboxylase activity of iris, spleen
and submaxillary gland after surgical sympathectomy, and a complete loss of tyrosine
hydroxylase activity of heart, submaxillary gland and kidney has been found after
surgical sympathectomy (POOL, COVELL, LEVITT, GIBB and BRAUNWALD, 1967;
SEDVALL and KOPIN, 1967; NAGATSU, RUST and DE QUATTRO, 1969). Although the
time course of the fall in DOPA decarboxylase and tyrosine hydroxylase activities
of operated vasa was not investigated, a preliminary experiment showed that all
DOPA decarboxylase activity was absent one day after denervation. Thus, it seems
likely that these two enzymes which are involved in the biosynthesis of NA have
a cellular localization within the sympathetic nerves of the vas deferens.
NORADRENALINE METABOLIZING ENZYMES IN
NORMAL AND SYMPATHETICALLY DENERVATED
VAS DEFERENS
B. JARROTTI and L. L. IVERSEN
Department of Pharmacology, University of Cambridge, Cambridge, England
(Received 5 May 1970. Accepted 21 May 1970)

Sympathectomy causes diminished capacity for physical sensation

Results: In the hot-plate analgesia test, sympathectomized rats increased their hot-plate latency time compared with that of sham-operated rats. Density of calcitonin gene-related peptide immunoreactive fibers in sympathectomy side of the lumbar dura mater decreased to 45.5% compared with the contralateral side. The number and size of calcitonin gene-related peptide immunoreactive cells in dorsal root ganglia showed no difference between sympathectomized and contralateral side.

Conclusion: Sympathectomy increased the pain threshold and made the sympathectomized rats hypesthetic.

An Anatomic Study of Neuropeptide Immunoreactivities in the Lumbar Dura Mater After Lumbar Sympathectomy.

Spine. 21(8):925-930, April 15, 1996.
Sekiguchi, Yasufumi MD *+; Konnai, Yasunobu MD *+; Kikuchi, Shinichi MD, PhD *; Sugiura, Yasuo MD, PhD +

Long-term superior cervical sympathectomy induces mast cell hyperplasia and increases histamine and serotonin content

Nerve fibres and mast cells are often described in close morphological and functional interactions in various organs such as the dura mater. The respective roles of mast cell activation and sympathetic impairment in cluster headache and migraine attacks have been repeatedly suggested. We have thus investigated the long-term effects of sympathectomy on mast cell morphology and content in the rat dura mater.
After unilateral ganglionectomy, the histamine content increased progressively and significantly 30–60 days post-surgery in both hemi-dura, whereas the serotonin content became significantly different from that of sham only 60 days post-surgery in the ipsilateral dura. After bilateral ganglionectomy, the histamine level significantly increased in both hemi-dura 15–60 days post-surgery, whereas the serotonin level had significantly increased at 60 days post-surgery.

These results clearly demonstrate, for the first time, a long-term trophic effect of sympathetic nerve degeneration on mast cells in the dura mater.

A. Bergerot^*, A. -M. Reynier-Rebuffel^†, J. Callebert^‡ and P. Aubineau

Copyright © 1999 IBRO. Published by Elsevier Science Ltd.

Mast cell hyperplasia: role of cytokines.

Bischoff SC, Sellge G.

Department of Gastroenterology, Hepatology and Endocrinology, Medical School of Hannover, Germany

Mast cell hyperplasia is found in different pathologies such as chronic inflammatory processes, fibrotic disorders, wound healing or neoplastic tissue transformation. The functional significance of the accumulation of mast cells in these processes is largely unknown. It is now established that bone marrow-derived mast cell progenitors circulate in peripheral blood and subsequently migrate into the tissue where they undergo final maturation under the influence of local microenvironmental factors. Cytokines are of particular importance for mast cell recruitment, development, and function. Stem cell factor (SCF) is a unique mast cell growth factor, since mast cells disappear completely in the absence of SCF. However, several other cytokines such as IL-3 and IL-4 have been shown to influence mast cell proliferation and function also. This review focuses on the role of cytokines in the regulation of mast cell hyperplasia. Copyright 2002 S. Karger AG, Basel

Int Arch Allergy Immunol. 2002 Feb;127(2):118-22.

Sympathectomy increases chronic DSS colitis

Sympathectomy reduced acute DSS colitis but increased chronic DSS colitis. Sympathectomy also increased chronic colitis in Il10–/– mice.

Anti-inflammatory role of sympathetic nerves in chronic intestinal inflammation

R H Straub¹, F Grum¹, U Strauch¹, S Capellino¹, F Bataille², A Bleich³, W Falk¹, J Schölmerich¹, F Obermeier¹

¹ Laboratory of Neuroendocrino-Immunology, Department of Internal Medicine I, University Hospital Regensburg, Germany
² Department of Pathology, University of Regensburg, Regensburg, Germany
³ Institute for Laboratory Animal Science and Central Animal Facility, Hannover Medical School, Hannover, Germany

Published Online First: 28 February 2008. doi:10.1136/gut.2007.125401
Gut 2008;57:911-921
Copyright © 2008 BMJ Publishing Group Ltd & British Society of Gastroenterology

destroying the sympathetic nerves and their ability to transmit impulses

Surgery (Endoscopic thoracic sympathectomy or ETS): Select sympathetic nerves or nerve ganglia in the chest are either cut or burned (completely destroying their ability to transmit impulses), or clamped (theoretically allowing for the reversal of the procedure). The procedure often causes anhidrosis from the mid-chest upwards, a disturbing condition. Major drawbacks to the procedure include thermo regulatory dysfunction (Goldstein, 2005), lowered fear and alertness and the overwhelming incidence of compensatory Hyperhydrosis. Some people find this sweating to be tolerable while others find the compensatory Hyperhydrosis to be worse than the initial condition. It has also been established that there is a low (less than 1%) chance of Horner's syndrome. Other risks common to minimally-invasive chest surgery, though rare, do exist. Patients have also been shown to experience a cardiac sympathetic denervation, which results in a 10% lowered heartbeat during both rest and exercise. ETS was thought to be helpful in treating facial blushing and facial sweating. According to Dr. Reisfeld,the only indication for ETS at present is excessive and severe palmar Hyperhydrosis (excessive hand sweating). Statistics have shown that when treated for facial blushing and/or excessive facial sweating, the failure rate of ETS for those two clinical presentations is higher and patients are more prone to side effects.
http://immersivemedical.com/hyperhydrosis_fr_2.html

Changes in Electrophysiology following sympathectomy

Chemical sympathectomy was obtained following intravenous injection of 50 mg·kg^–1 of 6-hydroxydopamine. 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, RÉGINALD A NADEAU and A ROBERT LEBLANC

From the Department of Physiology, Faculty of Medicine, Université de Montréal and Centre de recherche, Hôpital du Sacré-Coeur, Montréal, Canada

Cardiovascular Research 1982 16(9):524-529; doi:10.1093/cvr/16.9.524
© 1982 by European Society of Cardiology

Sympathectomy frequently causes perioperative hypotension

Vasomotor output is modified by inputs from throughout the central nervous system, including the hypothalamus, cerebral cortex, and the other areas in the brain stem. Areas in the posterolateral medulla receive input from both the vagal and the glossopharyngeal nerves and play an important role in mediating a variety of circulatory reflexes. The sympathetic system normally maintains some tonic vasoconstriction on the vascular tree. Loss of this tone following induction of anesthesia or sympathectomy frequently contributes to perioperative hypotension.

Clinical Anesthesiology

By G. Edward Morgan, Maged S. Mikhail, Michael J. Murray

Published by McGraw-Hill Professional, 2005

ISBN 0071423583, 9780071423588

hypoxic response after sympathectomy

Blockade of the sympathetic nervous system with {alpha} ... (9) reported a reduction in the hypoxic response of the lung after sympathectomy. ...
www.anesthesia-analgesia.org/cgi/content/full/88/3/494

by I Garutti - 1999

autoregulatory breakthrough is eliminated when the arterial baroreflex is interrupted

The effects of sympathetic section blockade are greater during systemic hypercapnia than during normocapnia: a decrease in cerebrovascular resistance has been demonstrated in cats and rabbits after bilateral sympathectomy when PaCO2 was below 62-67 mmHg.
Blockade of sympathetic activity causes a significant further increase in CBF during hypoxia.

..sympathetic activation exerts a significant protective action on CBF and blood-brain barrier (BBB) permeability (Bill and Lander 1976) an effect which is also seen in the presence of moderate increase increases in BP, where autoregulation maintains CBF almost constant.

The vasodilation which characterizes autoregulatory breakthrough is eliminated when the arterial baroreflex is interrupted (Talman et al. 1994), which suggests that it is an active process. It is possible that the breakthrough depends on release of nitric oxide or a NO donor associated with the removal of the sympathetic innervation of cerebral vessels (Talman and Dragon 1995).

Intoxications of the Nervous System

By Pierre J. Vinken, F. A. de Wolff, George W. Bruyn, Otto Appenzeller, Harold L. Klawans

Published by Elsevier Health Sciences, 1999

ISBN 0444828133, 9780444828132

Effects of Sympathetic Nervous System activation

Our previous work indicates that myocardial ischemia could be the mechanism responsible for the left ventricular (LV) dysfunction that frequently develops after massive sympathetic nervous system (SNS) activation. In this study, coronary blood flow (CBF) and myocardial ATP, creatine phosphate, and lactate concentrations were measured after massively activating the SNS of anesthetized rabbits with an intracisternal injection of veratrine. CBF was measured at time 0 (baseline), and at 2, 10, and 20 min after SNS activation in one group, and at 0, 45, 90, and 150 min in a second group. Myocardial ATP, creatine phosphate, and lactate were measured at 0, 2, 10, 20, 90, and 150 min in separate groups of rabbits. SNS activation caused LV dysfunction in 60% of the rabbits. SNS-related increases in CBF kept pace with the increases in myocardial energy demand as determined from the systolic pressure-heart rate product. The subendocardial-to-subepicardial blood flow ratio did not change significantly. Myocardial creatine phosphate concentration was depressed 2 min after SNS activation and remained depressed for at least 20 min. ATP fell continuously and was significantly lower than baseline by 20 min. Tissue lactate concentration was elevated at this time.
Jennifer M. Smith and Charles F. Pilati^,1

Department of Physiology, Northeastern Ohio University College of Medicine, Rootstown, Ohio 44272

Experimental Biology and Medicine 227:125-132 (2002)
© 2002 Society for Experimental Biology and Medicine

---

Orthostatic hypotension following sympathectomy can lead to syncope

8. Describe the reflex compensations when someone suddenly stands up from a supine position. What would happen in a patient who just had a sympathectomy?

Sudden standing causes pooling of blood in the leg veins. This results in decreased venous return to the heart, which leads to decreased cardiac output (Frank-Starling mechanism), which leads to decreased MAP. This decrease in MAP is detected by the carotid sinus baroreceptors, which relay a message to the medullary cardiovascular control center, which increases sympathetic outflow and decreases parasympathetic outflow, this causes:

• An increase in HR and myocardial contractility, tending to restore cardiac output.
• Vasoconstriction in skeletal musculature, skin, kidneys and gut, reducing blood flow to these organs and increasing TPR.
• Venoconstriction decreasing capacitance and increasing venous return

A patient with a sympathectomy would experience what's referred to as orthostatic hypotension (which might lead to syncope). Orthostatic hypotension is a decrease in arterial pressure when going from supine to a standing position. A person with a normal baroreceptor mechanism will try to restore MAP. In a person who had a sympathectomy, the sympathetic component of the baroreceptor mechanism is absent.

9. Will the capillary pressure increase or decrease in the following situations?

1. Arteriolar vasodilation: increase

2. Venodilation: decrease (however, Dr. Gray points out that capillary beds of lower extremities will experience an increase in pressure due to back pressure exerted by the column of blood in the dilated veins!)

M.A.S.T.E.R. Learning Program, UC Davis School of Medicine

Date Revised: Jan 16, 2002

Revised by: Gordon Li and Carolyn Nguyen

Marked MAP instability following sympathectomy

In this study, conscious freely behaving rats with functional sympathetic denervation of the vessels, as evidenced by the disappearance of pressor responses to tyramine, did not show any change in the mean level of blood pressure but had a striking increase in the spontaneous MAP (mean arterial pressure) variability as compared with intact rats. This exaggerated blood pressure lability was associated with an increase in the variability of mesentric conductance with no change in that of the hindquarters vascular bed, which is the sum of vascular conductances of all regional hemodynamic changes after sympathectomy and suggest that the sympathetic nervous system may play an important role in reducing short-term hemodynamic variability.
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. 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, by Jean Sassard

Under the patronage of: Ministère de la recherche et de la technologie, Ministère délégué à la santé, INSERM, CNRS (Départment des sciences de la vie), Conseil général du Rhône, Mairie de Lyon, Chambre de commerce et d'industrie de Lyon
Genetic Hypertension: Proceedings of the 7th International Symposium on SHR and Related Studies Held in Lyon (France), Ecole Normale Supérieure, October 28-30, 1991 = Hypertension Génétique

Sympathectomy for the treatment of Tachycardia

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

A J Turley, J Thambyrajah, A A Harcombe

Cardiothoracic Division, The James Cook University Hospital, Middlesbrough, UK

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.

Heart 2005;91:15-17
© 2005 by BMJ Publishing Group & British Cardiac Society

Fertility following sympathectomy

Both chemically and surgically induced sympathectomy increased the weight of the epididymis and seminal vesicles/coagulating glands as well as the number and the transit time of cauda epididymal sperm. Neither serum testosterone levels nor LH was affected by treatment with guanethidine. Using natural mating, no litters were produced by guanethidine-treated rats. Chemically denervated rats failed to produce copulatory plugs or ejaculate into the uterus. However, distal cauda epididymal sperm from chemically or surgically denervated rats displayed normal fertilization ability (80%) using in utero inseminations.
Biology of Reproduction 59, 897-904 (1998)
©Copyright 1998 Society for the Study of Reproduction, Inc.

Fertility of Rat Epididymal Sperm after Chemically and Surgically Induced Sympathectomy¹

Wilma De G. Kempinas^2,a, Juan D. Suarez^b, Naomi L. Roberts^b, Lillian F. Strader^b, Janet Ferrell^b, Jerome M. Goldman^b, Michael G. Narotsky^b, Sally D. Perreault^b, Donald P. Evenson^c, Deborah D. Ricker^d, , and Gary R. Klinefelter^b

Norepinephrine loss produces motor deficits

Norepinephrine loss produces more profound motor deficits than MPTP treatment in mice

1. K. S. Rommelfanger*,
2. G. L. Edwards†,
3. K. G. Freeman†,
4. L. C. Liles*,
5. G. W. Miller‡, and
6. D. Weinshenker*,§


Departments of *Human Genetics and
‡Environmental and Occupational Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322; and
†Department of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602
Edited by Richard D. Palmiter, University of Washington School of Medicine, Seattle, WA, and approved June 25, 2007 (received for review March 27, 2007)

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.

http://ajpheart.physiology.org/cgi/content/abstract/260/3/H827

Morphofunctional changes in the myocardium following sympathectomy

Vestn Akad Med Nauk SSSR. 1984;(2):80-5.
Related Articles, Links

[Morphofunctional changes in the myocardium following sympathectomy and their role in the development of sudden death from ventricular fibrillation]

[Article in Russian]

Beskrovnova NN, Makarychev VA, Kiseleva ZM, Legon'kaia , Zhuchkova NI.

Publication Types:

* English Abstract

Postoperative complications are frequent after sympathectomy

[Postoperative complications are frequent after surgery for palmar sweating and facial redness. Effects of the treatment must be considered with regard to the risk of side-effects]
[My paper] L Räf

Lakartidningen. 2001 Apr 11;98 (15):1764-5 11374001 (P,S,E,B)

inhalation of carbon dioxide

Minerva Med. 1958 Feb 14;49(13):514-6.Links
[Behavior of liquoral pressure after inhalation of carbon dioxide, as evaluative test of cerebral circulation with particular regard to treatment by sympathetic block in focal vascular cerebropathies.]
[Article in Italian]

POLETTI T, CAMERON-CURRY V, SGARBI M.

PMID: 13516803 [PubMed - OLDMEDLINE]

Cerebral accidents of vascular origin and cervical sympathectomy

Progr Med (Paris). 1955 Feb 10;83(3):43-7.Links
[Cerebral accidents of vascular origin and cervical sympathectomy.]
[Article in French]

CHAVANY JA, DJINDJIAN R, HAGEN-MULLER D.

Role of sympathectomy in the treatment of cerebrovascular occlusion

J Albert Einstein Med Cent (Phila). 1960 Jan;8:31-8.Links
Role of sympathectomy in the treatment of cerebrovascular occlusion.
SHENKIN HA, FINNESON BE.

Resection of the cervical sympathetic nerve in cerebrovascular diseases

Progr Med (Napoli). 1957 May 31;13(10):289-94.Links
[Resection of the cervical sympathetic nerve in cerebrovascular diseases.]
[Article in Italian]

POLETTI T, SGARBI M, CAMERON-CURRY

http://www.ncbi.nlm.nih.gov/pubmed/13453570?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=5&log$=relatedarticles&logdbfrom=pubmed

Acceptance by the medical community is not a substitute for rigorous testing

http://www.healthyplace.com/Communities/Depression/ect/news/newyork/krausstest.asp

A large proportion of psychiatrists claims ECT to be SAFE and EFFECTIVE. This is not the only parallel you can find between surgeons talking about ETS and psychiatrists talking about ECT.

TESTIMONY OF JOHN M. FRIEDBERG, M.D., NEUROLOGIST, BEFORE THE MENTAL HEALTH COMMITTEE OF THE NEW YORK STATE ASSEMBLY

MARTIN LUSTER PRESIDING

NYC, May 18, 2001

http://www.healthyplace.com/Communities/Depression/ect/news/newyork/friedbergtest.asp

From the ETS Discussion Forum

ETS surgeons should be measuring heart function, bronco-motor tone, thermoregulation, blood vessel constriction, and thyroid. They should be doing bone scans and exercise tests. They should measure changes in catecholomine levels. At least they should measure sweating. All of this is affected by ETS, and they simply dont want to know. Sorry, but the vast majority of ETS papers are not science. Dr. Goldstein at NIH is doing some good work, and showing some very disturbing results. All in all, ETS is still highly experimental, under-studied, and patients should be warned accordingly.

http://etsandreversals.yuku.com/reply/1861#reply-1861

Cervical sympathectomy in the treatment of cerebral vascular disorders

Lahey Clin Bull. 1953 Jul;8(5):142-8.Links
Cervical sympathectomy in the treatment of cerebral vascular disorders.
POPPEN JL, FAGER CA Jr.

PMID: 13070547 [PubMed - indexed for MEDLINE]

sympathectomy for palmar hyperhidrosis: effects on pulmonary function

In order to investigate the effect of sympathectomy, pulmonary function was compared before and four weeks after operation in 20 patients. Forced vital capacity (FVC) (-2.3%), forced expiratory volume in one second (FEV1) (-6.1%), and FEV1/FVC (-4.6%) were all slightly but significantly decreased four weeks after thoracoscopic sympathectomy. Also the instantaneous forced expiratory flow at 75%, 50% and 25% of the FVC (V_max 25, V_max 50, V_max75) in flow-volume curves were decreased (-1.6%, 8.4%, and -20% respectively). Therefore, thoracoscopic sympathectomy minimises pulmonary restrictive effects but allows subclinical small airway obstructive effects to become more evident.

TSENG Ming-Yuan ⁽¹⁾ ; TSENG Jen-Ho ⁽¹⁾ ;
⁽¹⁾ Division of Neurosurgery, Department of Surgery, Medical School and Hospital, National Taiwan University, 7 Chung-Shan South Road, Taipei, TAIWAN, PROVINCE DE CHINE
Journal of clinical neuroscience ISSN 0967-5868
2001, vol. 8, n^o6, pp. 539-541 (29 ref.)

Cerebral infarction due to carotid occlusion and carbon monoxide exposure. II. Influence of preganglionic cervical sympathectomy.

J Igloffstein and R Laas
J Neurol Neurosurg Psychiatry. 1983 August; 46(8): 768–773.

Unilateral cerebral infarcts were produced in the rat by ligation of one common carotid artery and subsequent exposure to carbon monoxide. The incidence and extension of brain infarcts was increased in animals with additional ipsilateral cervical preganglionic sympathectomy. Sympathectomy did not affect markedly the respiration and systemic circulation. The effect of sympathectomy was attributed to a cutaneous vasodilation, leading to an extracranial steal phenomenon.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1027532

Elevated levels of TH in major depression and after sympathectomy

Zhu MY, Klimek V, Dilley GE, Haycock JW, Stockmeier C, Overholser JC, Meltzer HY, Ordway GA.
Elevated levels of tyrosine hydroxylase in the locus coeruleus in major depression.
Biol Psychiatry. 1999 Nov 1;46(9):1275-86.

CONCLUSIONS: Elevated expression of TH in the LC in major depression implies a premortem overactivity of these neurons, or a deficiency of the cognate transmitter, norepinephrine."

Adrenal Tyrosine Hydroxylase: Compensatory Increase in Activity after Chemical Sympathectomy

Robert A. Mueller ¹, Hans Thoenen ¹, and Julius Axelrod ¹

¹ Laboratory of Clinical Science, National Institute of Mental Health, Bethesda, Maryland 20014

Destruction of peripheral sympathetic nerve endings with 6-hydroxydopamine causes a disappearance of cardiac tyrosine hydroxylase, accompanied by a twofold increase in adrenal tyrosine hydroxylase and a small increase in phenyl-ethanolanine-N-methyl transferase.

Sympathectomy resulted in reduced antibody responses to T-dependent antigens

It has been exhaustively demonstrated that the regions in which lymphocytes T cells reside, and through which they recirculate, receive direct sympathetic neural input. Therefore, the immune system can be considered “hard-wired” to the brain. Chemical sympathectomy of adult mice resulted in reduced antibody responses to T-dependent antigens.

VOL. 31, NOS. 5 & 6, 2000 JOURNAL OF MEDICINE

JOURNAL OF MEDICINE, 2000

ENHANCEMENT OF NORADRENERGIC NEURAL TRANSMISSION: AN EFFECTIVE THERAPY OF

MYASTHENIA GRAVIS
Fuad. Lechin^1,2, Bertha van der Dijs^1,2, Betty Pardey-Maldonado¹,

Eduardo Jahn¹, Vladimir Jimenez¹, Beatriz Orozco¹,Scarlet Baez² and Marcel E. Lechin³

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 eliminates the circadian rhythm of BP, and the circadian rhythms of BP and HR are modulated by the autonomic nervous system in rats. The circadian rhythms of BP and HR are regulated by different mechanisms involving the autonomic nervous system.

Chemical sympathectomy with guanethidine may activate the influence of the parasympathetic
nervous system on the heart. The possible reasons for the decrease of MBP during the dark period seem to be the elimination of the sympathetic nervous system or the activation of the
parasympathetic nervous system, or both. Because the SBP and PP in sympathectomized rats during the dark period were suppressed, the decrease of stroke volume, which is reflected in SBP or PP, may be responsible for the decrease of MBP during the dark period. It seems definitive,
therefore, that the autonomic nervous system, particularly the sympathetic nervous system, is
important for the manifestation of 24-hour rhythms of BP and HR in rats.

The daily variations in MBP in intact rats, in which an abrupt rise was seen when the light was
turned off and a sharp fall in MBP was seen when the light was turned on, were not observed in sympathectomized rats. These results suggest that a change in autonomic nervous tone, the majority being the sympathetic nervous tone, is required for the abrupt changes in BP at the time when the lighting is altered. In humans, BP often rises abruptly around the time of awakening.1 If this early morning surge in BP were due to the same mechanisms as in rats, a change in autonomic nervous tone would be important for the formation of this morning surge in humans. In fact, -sympathetic vasoconstrictor activity is reportedly related to this early morning surge.
Furthermore, the autonomic nervous system may play some role in the high correlation between the HR and locomotor activity, because the slope of the regression line was decreased in sympathectomized rats. The correlation between the MBP (mean blood pressure) and locomotor activity was disrupted by both SAD and chemical sympathectomy.

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

(Circulation. 1997;96:1667-1674.)
© 1997 American Heart Association, Inc.
Mitsutaka Makino, MD; Hiroshi Hayashi, MD;
Hiroto Takezawa, MD; Makoto Hirai, MD;
Hidehiko Saito, MD; ; Shizufumi Ebihara, PhD

Hemodynamic changes after sympathectomy and the number od sympathetic segments operated

After ETS, heart rate, systolic, diastolic, and mean blood pressures, rate-pressure product, and NOR decreased,whereas left ventricular end-systolic volume index, cardiac index, and ejection fraction did not change in the 2 groups.Among percent changes in all hemodynamic parameters and NOR occurring after ETS, only the percent decrease in systolic blood pressure in group Th2–4 was larger than that in group Th2–3 (–15 ± 12 % vs.–4±8%, respectively, p <>

Yukio Nakamura¹, Shin-ichiro Muramoto¹, Rira Kato¹, Takahiro Saeki¹, Manabu Fujimoto¹, Hiroshi Kida¹ and Yasushi Matsumoto²

(1)	Dept. of Cardiology, Kanazawa National Hospital, 1-1 Shimoishibiki-machi, Kanazawa, Ishikawa, 920–8650, Japan

(2)	Dept. of Cardiovascular Surgery, Kanazawa National Hospital, Kanazawa, Ishikawa, Japan

Sympathectomy as a treatment for Social Phobia

Pohjavaara P, Telaranta T, Väisänen E.

Tampere City Mental Health Care Centre, Finland. paipoh@koti.soon.fi

Social phobia is a neglected disorder, which can cause very debilitating consequences in patients' lives. The patients tend to isolate and suffer from comorbid disorders such as depression, other anxiety disorders, and drug and alcohol abuse. Traditional treatment methods such as medication and psychotherapy do not help everyone. A prospective, uncontrolled follow-up study with 169 social phobic patients was performed by uni- or bilateral endoscopic sympathetic block of the upper thoracic ganglia.

Endoscopic sympathetic block is recommended as the treatment of choice in severe, conservative therapy resistant social phobia.
Ann Chir Gynaecol. 2001;90(3):177-84.

Psychoneurological applications of endoscopic sympathetic blocks

Telaranta T.

University of Oulu, Oulu, Finland. timo.telaranta@privatix.fi

In addition to more widely and longer known indications of ETS, various neurological disorders and psychologically stressful situations in their worst expressions might be alleviated by the reversible ESB procedure. The patients with social phobia, especially those who have also blushing and/or stage fright type of heart racing, benefit from the ESB. The disturbances of the sympathetic nervous system, e. g. in Parkinson's disease and multiple system atrophy might be alleviated with sympathetic block, especially the extrapyramidal symptoms in these diseases. In migraine, sympathetic surgery has been noted to give some help. The unilateral left-sided block has been effective in long QT-syndrome type arrhythmias. In schizophrenia, the phobic, paranoic or confusional reactions have been tentatively treated by the sympathetic block.

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=14673667&dopt=AbstractPlus

Vasodilator response to mental stress absent after sympathectomy

The idea that there might be sympathetic vasodilator nerves to skeletal muscle is an old concept that fits with the archaic `fight or flight' model of the sympathetic nervous system. Clear evidence for vasodilator nerves to skeletal muscle began to emerge in animals during the 1930s, when stimulation of selected brainstem areas was shown to evoke hypertension, tachycardia and skeletal muscle vasodilation (i.e. the `defense reaction'). By the 1940s and 1950s this idea was well established and it was shown in animals that the sympathetic dilator nerves to muscles were cholinergic. During this time, circumstantial evidence began to suggest the existence of sympathetic cholinergic vasodilator fibres in human skeletal muscle. In this context, the well- known forearm vasodilator response to mental stress was shown to be atropine-sensitive, and absent after surgical sympathectomy.

Sympathetic vasodilation in human muscle

Authors: Joyner, M. J.¹; Dietz, N. M.¹

Source: Acta Physiologica, Volume 177, Number 3, March 2003 , pp. 329-336(8)

Publisher: Blackwell Publishing

Tyrosine hydroxylase, DOPA and catecholamines

Tyrosine hydroxylase (TH) mRNA and activity and concentrations of 3,4-dihydroxyphenylalanine (DOPA) and catecholamines were examined as markers of sympathetic innervation and catecholamine synthesis in peripheral tissues of sympathectomized and intact rats. Chemical sympathectomy with 6-hydroxydopamine (6-OHDA) markedly decreased norepinephrine and to a generally lesser extent TH activities and dopamine in most peripheral tissues (stomach, lung, testis, duodenum, pancreas, salivary gland, spleen, heart, kidney, thymus). Superior cervical ganglia, adrenals and descending aorta were unaffected and vas deferens showed a large 92% decrease in norepinephrine, but only a small 38% decrease in TH activity after 6-OHDA.
Differential Effects of Chemical Sympathectomy on Expression and Activity of Tyrosine Hydroxylase and Levels of Catecholamines and DOPA in Peripheral Tissues of Rats
Journal Neurochemical Research
Publisher Springer Netherlands Issue Volume 24, Number 1 / January, 1999

sympathectomy prevents them from responding to reflex or emotional changes in the central nervous system - psychosurgery

All the sympathetic ganglia that send postganglionic nerve fibres to structures in the head, neck and upper limb receive preganglionic fibres from the central nervous system only through the white rami communicates of the upper thoracic ventral rami. These preganglionic fibres ascend in the trunk and reach its ganglia directly and outlying ganglia through branches of the trunk. Thus destruction of the trunk at the root of the neck, whether as a result of a surgery (cervical sympathecotmy) or of some pathological condition, isolates all these sympathetic ganglion cells from the central nervous system and prevents them from responding to reflex or emotional changes in the central nervous system.
Cunningham's Manual of Practical Anatomy: Volume III: Head, Neck and Brain (Oxford Medical Publications)
G. J. Romanes
Paperback - Nov 20, 1986, page 87

Does bilateral thoracic sympathectomy predispose to reflex bronchospasm following tracheal intubation?

Patients with essential hyperhidrosis have sympathetic overactivity, associated with compensatory high parasympathetic tone. Sympathectomy results in a decrease of plasma norepinephrine,³ and parasympathetic predominance4 which may increase airway resistance.⁵ Intraoperative bronchospasm is usually cholinergically-mediated. Thus, patients with essential hyperhidrosis who have undergone bilateral thoracic sympathectomy, may be more liable to develop reflex bronchospasm under light levels of anesthesia.
Ahed Zeidan, MD^*, Nazih Nahle, MD^* and Anis Baraka, MD FRCA
Canadian Journal of Anesthesia 52:997-998 (2005)
© Canadian Anesthesiologists' Society, 2005

The severity and manifestations of the autonomic hyperreflexia are affected by the level of the sympathectomy

Autonomic Hyperreflexia is caused by noxious stimulation below the level of the lesion in a patient with a sympathectomy at or above T6.

...The efferent sympathetic fibers recover from the initial injury but remain unaffected by central inhibitory input from the brain stem and hypothalamus.
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

Contributor Philippa Newfield, Stephen Onesti, James E. Cottrell

Published 2006, Lippincott Williams & Wilkins

Results deteriorate progressively

Intermediate-term results of endoscopic transaxillary T2 sympathectomy for primary palmar hyperhidrosis. Chiou T S-M, Chen S-C. Br J Surg 1999; 86: 45-47.

It was concluded that the results of endoscopic sympathectomy deteriorated progressively from the immediate outcome and the compensatory hyperhidrosis was the principal reason for dissatisfaction.

It can diminish the body's physical reaction to exercise and/or strong emotion, and thus is considered 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
http://web.archive.org/web/20060706140821/www.lvhyperhidrosis.com/ets.html

Dr Nagy, Las Vegas

Electrical instability of the heart following desympathization

Arkh Patol. 1981;43(6):18-24.Links

Beskrovnova NN, Ul'ianinskiĭ LS, Makarychev VA, Vikhert AM.

The time course of ultrastructural and electrophysiological disorders and their role in sudden death of ventricular fibrillation at various intervals of desympathization caused by reserpine administration were studied. Early in the effect of reserpine (up to 30 min), glycogen granules were found to accumulate in the sarcoplasm of cardiomyocytes. At later intervals (1-24 hours), along with glycogen accumulation destructive lesions of organoids were observed in the form of myofibrillar recontraction, destruction of mitochondria, degeneration of sarcolemma. These changes are morphologic reflections of metabolic disorders developing in the myocardium under conditions of acute desympathization of the patient, and may be one of the causes of increased vulnerability of the heart in fibrillation.

Sympathectomy and avoidance learning

Di Giusto, E. L.; King, M. G.

Journal of Comparative and Physiological Psychology. 1972 Dec Vol 81(3) 491-500

Reports results of 5 experiments with male Wistar rats (N = 108). Depletion of peripheral sympathetic noradrenaline induced by administration of 6-hydroxydopamine, ip, led to significant decrements in escape and avoidance responding when the required response was difficult, but not when it was relatively easy to acquire. Results are similar to previous findings obtained with adrenal-demedullated Ss. Findings clarify the role of the sympathetic nervous system in the motivation of behavior elicited by aversive stimulation.
http://psycnet.apa.org/index.cfm?fa=main.doiLanding&uid=1973-08610-001

Morphofunctional changes in the myocardium following sympathectomy

Vestn Akad Med Nauk SSSR. 1984;(2):80-5.

Related Articles, Links

Morphofunctional changes in the myocardium following sympathectomy and their role in the development of sudden death from ventricular fibrillation

Beskrovnova NN, Makarychev VA, Kiseleva ZM, Legon'kaia , Zhuchkova NI.

http://www.ncbi.nlm.nih.gov/pubmed/6711115?dopt=Abstract

Cervical sympathectomy causes photoreceptor-specific cell death in the retina

Jena J. Steinle, Naarah L. Lindsay and Bethany L. Lashbrook

Department of Physiology, Southern Illinois University School of Medicine, Carbondale, IL 62901, United State, 2005.

The current study was designed to determine whether changes induced by sympathetic denervation causes significant loss of photoreceptors and increased glial cell reactivity in the retina. Sympathetic denervation was performed followed by immunohistochemistry, TUNEL staining, and protein expression analysis to investigate photoreceptor loss. There was a significant reduction (30%) in photoreceptor numbers in the sympathectomized eye. This loss was due to apoptosis, as there was over a doubling in apoptotic cell numbers after sympathectomy. This loss of photoreceptors in the sympathectomized eye resulted in a significantly reduced width of the outer nuclear layer of the retina when compared to the contralateral eye. Increased glial fibrillary acidic protein (GFAP) staining was also noted after sympathectomy in the ganglion cell layer with streaking toward the bipolar cell layer. These results suggest that loss of sympathetic innervation may cause significant changes to the physiology of the choroid.

sympathectomy enhances the severity of EAE

Regarding the modulation of autoimmunity, it was previously demonstrated that depletion of SNS transmitters by chemical sympathectomy enhances the severity of EAE (Experimental Autoimmune Encephalomyelitis.
Chelmicka-Schorr, E., M. Checincski, B. G. M. Arnason. 1988. Chemical sympathectomy augments the severity of experimental allergic encephalomyelitis. J. Neuroimmunol. 17:347.[Medline]
The Journal of Immunology, 2003, 171: 3451-3458. Copyright © 2003 by The American Association of Immunologists

Sammy Bedoui*, Sachiko Miyake*, Youwei Lin*, Katsuichi Miyamoto*,
Shinji Oki*, Noriyuki Kawamura*, Annette Beck-Sickinger ,
Stephan von Hörsten and Takashi Yamamura2,*

Loss of sensory innervation induces remarkable changes in the nerves that remain

The autonomic nervous system: Dysfunctions

Chemical denervation and selected ganglionectomy studies have shown that loss of sympathetic or sensory innervation induces remarkable changes in the nerves that remain...
Following chronic guanethidine sympathectomy there is complete depletion of sympathetic cotransmitters NA and NPY from the dura mater but an increase in the the expression of NPY in non-sympathetic axons (lacking small dense covered vesicles) supplying cerebral vessels and the iris. (Mione et al. 1990). The source of increased cerebrovascular NPY is thought to be preexisting parasympathetic cranial ganglia...(Gibbins and Morris 1988).

Indeed, sympathectomy-induced increased DBH-immunoreactivity in the sphenopalatine (parasympathetic) ganglion occurs at the same time as a loss in VIP-immunoreactivity (Fan and Smith 1993). In the cerebral artery and uterine artery, loss of sympathetic nerves also leads to increased DBH-immunoreactvity in non-sympathetic nerves that lack TH and NA (Morris et al. 1987); Mione et al. 1991)

In the lung, sympathectomy induces a marked increse in CGRP-immunoreactive nerve density around the airways, blood vessels and also in the vicinity of the neurepithelial bodies of the pulmonary epithelium (Van Ranst and Lauweryns 1990).
page 110,

By Otto Appenzeller, P. J. Vinken, G. W. Bruyn,

Contributor Otto, Appenzeller, P. J. Vinken, G. W. Bruyn

Published 2000 Elsevier Health Sciences

Autonomic nervous system / Pathophysiology

histochemical comparison of the normal and chronically sympathectomized heart

Jones CE, Cannon MS.

Using histochemical techniques, the reactivities of selected enzymes and other metabolic components were examined in the myocardium, coronary arteries, and coronary arterioles of normal, two-week-sympathectomized, and sham-operated canine hearts. There were no differences in the histochemistry of coronary arteries in any of the hearts, but important differences were noted in the myocardium and especially in the arterioles. The reactivities of the enzyme glucose-6-phosphate dehydrogenase and the nucleic acids were increased in arterioles of the sympathectomized heart, possibly indicating an increased protein synthesis. The reactivities of succinate dehydrogenase, NAD-isocitrate dehydrogenase, and cytochrome oxidase were reduced in myocardium and arterioles of sympathectomized hearts as well as in arterioles of sham-operated hearts; the changes were greater in the sympathectomized arterioles where there was also observed an increase in reactivity of lactate dehydrogenase. These findings suggest a depression in aerobic metabolic capacity and, in the case of the sympathectomized arteriole, imply a possible shift in adaptation from aerobic to anaerobic metabolism.
Histochem J. 1980 Jan;12(1):9-22.

Upregulation of Neuropeptide Y

Migraine and Headache Pathophysiology - Google Books Result

by Lars Edvinsson, Lars Edvinsson Edvinsson - 1999 - Medical - 184 pages
The mRNA may thus only indicate the possibility of forming the receptor protein. After sympathectomy an upregulation of NPY, probably of parasympathetic origin can be seen in some target organs.
books.google.com.au/books?isbn=1853177377...

Increased ,&Nerve Growth Factor Messenger RNA and Protein

Peripheral NGF mRNA and protein levels following
sympathectomy
It has been shown previously that peripheral sympathectomy
causes a dramatic increase in NGF levels in the denervated
organs (Yap et al., 1984; Kanakis et al., 1985; Korsching and
Thoenen, 1985).
Increased ,&Nerve Growth Factor Messenger RNA and Protein
Levels in Neonatal Rat Hippocampus Following Specific Cholinergic
Lesions
Scott R. Whittemore,” Lena Liirkfors,’ Ted Ebendal,’ Vicky R. Holets, 2,a Anders Ericsson, and HBkan Persson
Departments of Medical Genetics and’ Zoology, Uppsala University, S-751 23 Uppsala, Sweden, and *Department of
Histology, Karolinska Institute, S-104 01 Stockholm, Sweden

Effect of sympathetic denervation on the rate of protein synthesis

On the other hand, clenbuterol or epinephrine (10-5 M) increased by 20% the rate of protein synthesis in soleus muscles from adrenodemedullated rats and prevented its decrease in muscles from fasted rats. The data suggest that the sympathetic nervous system stimulates protein synthesis in oxidative muscles, probably through the activation of {beta}2-adrenoceptors, especially in situations of hormonal or nutritional deficiency.
Luiz Carlos C. Navegantes, Neusa M. Z. Resano, Amanda M. Baviera, Renato H. Migliorini, and Isis C. Kettelhut

Department of Physiology, Biochemistry and Immunology, School of Medicine, University of São Paulo, 14049-900 Ribeirão Preto, São Paulo, Brazil

Submitted 18 August 2003 ; accepted in final form 28 November 2003

Recurrence of original symptoms

The global recurrence rate was 8.8%: 6.6% for palmar hyperhidrosis and 65% for axillary hyperhidrosis. Compensatory sweating was observed in 86.4% of the patients. It was considered as minor by 61% of them, as embarrassing by 31.5%, and as disabling by 7.5%. Other reported side effects were: Horner's syndrome in 3 patients (2.4%), healing in 2 of them; chronic rhinitis in 3 (2.4%); gustatory sweating in 9 (7.2%); and hand dryness in 42%.

Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis.

Gossot D, Galetta D, Pascal A, Debrosse D, Caliandro R, Girard P, Stern JB, Grunenwald D.

Thoracic Department, Institut Mutualiste Montsouris, Paris, France

http://www.ncbi.nlm.nih.gov/pubmed/12683540?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=5&log$=relatedarticles&logdbfrom=pubmed

Number of unsatisfied patients after T2, T3 Sympathectomy

moderate-to-severe reflex sweating was more common in the ETS2 and ETS3 groups. About 40% of ETS2 groups and 25% of ETS3 group patients were unsatisfied with their operation.

Mahdy T, Youssef T, Elmonem HA, Omar W, Elateef AA.

Department of Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Surgery. 2008 Jun;143(6):784-9. Epub 2008 Mar 20

sympathectomy impairs bone resorption

the sympathetic nervous system is not involved in osteoclast precursor recruitment; but has a significant effect on resorption by inhibiting preosteoclast differentiation and disturbing osteoclast activation. These data suggest that depletion of sympathetic mediators may disturb osteogenic cell-mediated osteoclast differentiation.
M Cherruau1, P Facchinetti2, B Baroukh1, J.L Saffar1

Received 2 November 1998; received in revised form 14 May 1999; accepted 9 July 1999.

http://www.journals.elsevierhealth.com/periodicals/bon/article/PIIS8756328299002112/abstract

Lumbar Sympathectomy - ejaculatory impotence and anorgasmia are almost certain consequences

European Handbook of Dermatological Treatments - Google Books Result

by Andreas D. Katsambas, Torello M. Lotti - 2003 - Medical - 804 pages
However, lumbar sympathectomy has no place in the treatment of pedal hyperhidrosis since ejaculatory impotence and anorgasmia are almost certain consequences ...

Mia: Lumbar Sympathectomy is still being offered by many surgeons as an effective and safe treatment for pedal hyperhidrosis.

Sympathalgia of the cervicobrachial region

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).
Gross D.
1: MMW Munch Med Wochenschr. 1979 Sep 14;121(37):1167-72.

local heterogeneous changes in cerebral blood flow

The local influence of sympathetic stimulation on the cerebral circulation during acute hypertension was investigated in anesthetized rats. From initial studies, intravenously administered angiotensin II was selected as the pressor agent. Local cerebral blood flow was measured with [14C]iodoantipyrine autoradiography during 1) unilateral electrical stimulation of the superior cervical ganglion plus moderate hypertension [mean arterial blood pressure (MABP) 162 +/- 2 mmHg], 2) unilateral stimulation plus severe hypertension (MABP 177 +/- 4 mmHg), and 3) unilateral preganglionic sympathetic nerve section (denervated) plus severe hypertension (MABP 186 +/- 4 mmHg). During moderate hypertension, blood flow was rather homogeneous and sympathetic stimulation produced modest (7-15%) regionally specific reductions in flow ipsilateral to the stimulation (P less than 0.05). During severe hypertension: 1) focal areas of marked hyperemia occurred throughout the brain, 2) local blood flow was similar within innervated and denervated hemispheres, and 3) with sympathetic stimulation the volume of hyperemic tissue was reduced ipsilaterally and blood flow was decreased by 7-25% in areas of basal ganglia, cerebral cortex, limbic system and thalamus. To conclude, 1) the local cerebral autoregulatory response is highly dependent on whether the area becomes hyperperfused and 2) sympathetic stimulation decreases brain blood flow by modestly reducing local tissue perfusion and by lessening the volume of extreme hyperemia.

U. I. Tuor
Division of Neonatology, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.

Am J Physiol Heart Circ Physiol 263: H511-H518, 1992;