The pattern is symmetrical with sweating involving the head and exceptionally the neck, and with flushing most apparent in the nose and cheek (Haxton 1948; Monro 1959, Fox et al. 1962; Drummond and Lance 1987).
Aberrant regeneration following sympathectomy can give rise to pathological gustatory facial flushing and sweating. Weeks, months, or years after cervicothoracic preganglionic sympathectomy, gustatory sweating and flushing may develop on the denervated side along with impaired thermoregulatory sweating. (Bloor 1969; Kurchin at al. 1977)
Sympathetic preganglionic fibers originally destined for the salivary glands may be responsible through faulty reinnervation of the stellate ganglion... (Bloor, 1969; Drummond and Lance 1987).
Interruption of postganglionic sympathetic facial fibers may render residual neurilemmal sheaths and sympathetic endings susceptible to stray collateral sprouting or faulty regeneration of parasympathetic fibers that normally mediate salivation.
Pathological gustatory sweating and flushing can develop
after injury to preganglionic cervicothoracie sympathetic fibres, an
unavoidable consequence of resecting that part of the sympathetic chain. The
mechanism of this abnormal response is uncertain; conceivably, though,
regeneration of injured salivatory fibres or collateral sprouting from nearby
intact fibres creates aberrant connections between salivatory fibres and
denervated vasomotor and sudomotor neurons in the superior cervical ganglion. 7
Commands to salivate would then be translated into commands to sweat and flush
in the distribution of sympathetic denervation. Cross-innervation lower down in
the stellate ganglion can also produce unusual and potentially distressing
autonomic disturbances in the sympathetically denervated arm (e.g.
piloerection while eating)
P.D.DRUMMOND
School of Psychology, Murdoch University,
South Street, Murdoch,
