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

Thursday, December 18, 2008

lack of free noradrenaline after sympathectomy

The similarity of the ultrastructural changes in the light pinealocytes occurring after sympathectomy and after continuous illumination was striking. It is supposed that these changes have a common cause,viz. the lack of free noradrenaline, the pinealotropic neurotransmitter.
Journal of Neural Transmission Volume 36, Numbers 3-4 / September, 1975
http://www.springerlink.com/content/j121443576128248/

SYMPATHETIC REINNERVATION DOES NOT RESTORE NORMAL FUNCTION

SYMPATHETIC REINNERVATION OF THE PINEAL GLAND AFTER
POSTGANGLIONIC NERVE LESION DOES NOT RESTORE NORMAL
PINEAL FUNCTION’
C. W. BOWERS,’ C. BALDWIN, AND R. E. ZIGMOND3
Department of Pharmacology, Harvard Medical School, Boston, Massachusetts 02115
Received October 6, 1983; Revised January 5, 1984; Accepted February 17, 1984

www.jneurosci.org/cgi/reprint/4/8/2010.pdf

Degeneration activity of the pineal gland after sympathetic denervation

The present findings confirm that, in endocrine glands and similarly to other autonomically innervated organs, acute denervation induces degeneration acitivity.
http://www.springerlink.com/content/u573421xk753rk83/

Syncope - neurologic or mechanical causes

among others:
Shy-Drager syndrome
Sympathectomy
Primary autonomic insufficiency
http://www.wrongdiagnosis.com/j/jervell_and_lange_nielsen_syndrome/book-diseases-6a.htm

side effects, ranging from trivial to devastating

There seem to be no controlled studies demonstrating efficacy of neurolytic sympathetic blocks. Possible side effects, ranging from trivial to devastating, are of even greater importance with these more permanent procedures—painful sequelae may include phe-
nol or alcohol neuritis and postsympathectomy pain (sympathalgia), which can also occur after surgical sympathectomy.

The involvement of the sympathetic nervous system in causalgia and reflex sympathetic dystrophy, which for ms the rationale for treatment by sympathetic interruption, has been questioned, and the issues discussed here raise further questions. Contrary to predictions from experimental data, interrupting the sympathetic nervous system in practice seems futile for obtaining long term relief of pain in many if not most of these patients. How to identify the minority of patients whose pain might respond to these procedures is the next task, but fresh approaches to management are also required.

G D Schott Consultant neurologist
Interrupting the sympathetic outflow in causalgia and reflex sympathetic dystrophy - A futile procedure for many patients
The National Hospital for Neurology and Neurosurgery, London
1998;316;789-790 BMJ

20% of patients attending chronic pain clinics implicated surgery as one of the causes of their chronic pain

Chronic pain after surgery has until recently been a neglected topic. The extent of the problem first came to light in a survey of patients attending pain clinics in Scotland and the north of England.17 This survey showed that about 20% of patients attending chronic pain clinics implicated surgery as one of the causes of their chronic pain and, in about half of these, it was the sole cause. An extensive literature search failed to produce any references on the general topic of chronic pain after surgery. There were, however, almost 400 references on chronic pain after specific operations, such as mastectomy, cholecystectomy and thoracotomy. The information from this literature search formed the basis of a chapter, entitled ‘Chronic postsurgical pain’,33 in Epidemiology of Pain, edited by I. K. Crombie and published by the IASP Press in 1999.
http://bja.oxfordjournals.org/cgi/content/full/87/1/88?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=sympathectomy&searchid=1&FIRSTINDEX=20&resourcetype=HWCIT

Blood diverted from muscle to skin after sympathectomy

However, the clinical results of both surgical and neurolityc sympathectomy are uncertain. Indeed these procedures lead to a redistribution of the blood flow in the lower limbs from the muscle to the skin, with a concomitant fall of the regional resistance, mainly in undamaged vessels. The blood flow will be diverted into this part of the vascular tree, so that a
"stealing" of the blood flow may occur.
Vito A. Peduto, Giancarlo Boero, Antonio Marchi, Riccardo Tani
Bilateral extensive skin necrosis of the lower limbs following prolonged epidural blockade
Anaesthesia 1976; 31: 1068-75.

excessive intracranial hypertension following sympathectomy

Increase in Kaolin-Induced Intracranial Hypertension after Decentralization of the Superior Cervical Sympathetic Ganglia in Rabbits

In fact, most of the animals in this group died in the course of the experiment, due to the excessive intracranial hypertension which was more than a tenfold increase compared to normal rabbits. It is suggested that the increased VFP following sympathetic denervation is a result of increased cerebral blood volume (vasodilation) together with increased production of cerebrospinal fluid (loss of inhibitory adrenergic nerve activity in the choroid plexuses).

L. Edvinsson, K.C. Nielsen, C. Owman, K.A. West

Departments of Histology and Neurosurgery A, University of Lund, Lund, and Neurosurgical Clinic, University Hospital, Umeå

Address of Corresponding Author

Eur Neurol 1974;11:296-303 (DOI: 10.1159/000114327)

http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=114327&Ausgabe=234447&ProduktNr=223840&filename=114327.pdf

inflammation and pain in teeth

Unilateral sympathectomy induced a significant increase in cell density both in the inflamed and in the uninflamed dental pulp bilaterally. Our results demonstrate, for the first time, a trophic effect of the sympathetic nerves on cells in the dental pulp, indicating that an imbalance of sympathetic nerves may induce inflammation and pain in teeth.
Received 7 July 2000; accepted 8 January 2001. ;
Available online 4 March 2002.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WFG-458NJTW-2R&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=3f63f4106e411d92b1ce5168c2b07fde

Circulatory changes in the blood flow in the human skin and muscle following sympathectomy.

J Physiol. 1951 Sep ;115 (1):9p-10p 14889441 (P,S,G,E,B)


K K CHENG
Q J Exp Psychol. 1949 Jun ;35 (2):135-43 18135572 (P,S,G,E,B)

Influence of sympathectomy in humans on the rhythmicity of 6-sulphatoxymelatonin urinary excretion - effect on pineal gland

Morten Møller, Ole Osgaard, Michael Grønbech-Jensen
Inst. Med. Anatomy, University of Copenhagen, Panum Institute, Blegdamsvej 3, DK-2200 Copenhagen, Denmark.
The amount of 6-sulphatoxymelatonin, the chief metabolite of melatonin, in the urine was measured in nine patients, who were subjected to bilateral sympathectomy at the second thoracic ganglionic level for treatment of hyperhidrosis of the palms. All patients showed before surgery a normal 6-sulphatoxymelatonin excretion with a peak in the excretion during the night time. After the sympathectomy, the high night time excretion was clearly abolished in five patients but remained high in four patients. This indicates that the segmental locations of the preganglionic sympathetic perikarya in the spinal cord, stimulating the melatonin secretion in the pineal gland in humans, vary between individuals. An increase in daytime melatonin excretion was observed in the patients responding to the sympathectomy with an abolished 6-sulphatoxymelatonin rhythm. This increase could indicate that the final sympathetic neurons innervating the pineal gland might have a both stimulatory and inhibitory function.

http://lib.bioinfo.pl/pmid:16647807
Mol Cell Endocrinol. 2006 Apr 27; : 16647807 (P,S,G,E,B,D)
Sympathectomy decreases and adrenergic stimulation increases the release of tissue plasminogen activator (t-PA) from blood vessels: Functional evidence for a neurologic regulation of plasmin production within vessel walls and other tissue matrices

Journal of Neuroscience Research

Published Online: 25 Aug 1999
http://www3.interscience.wiley.com/journal/63500193/abstract?CRETRY=1&SRETRY=0

Effect of cardiac catecholamine depletion through sympathectomy on spontaneous ventricular fibrillation during induced hypothermia in cats

Cellular and Molecular Life Sciences (CMLS)
Volume 24, Number 12 / December, 1968
SpringerLink DateFriday, September 30, 2005
http://www.springerlink.com/content/k391462541tk34x3/

Sympathectomy for Jervell and Lange-Nielsen syndrome

Jervell and Lange-Nielsen syndrome: neurologic and cardiologic evaluation - An indication for cervicothoracic sympathectomy

Authors: Ilhan A.1; Tuncer C.; Komsuoglu S.S.; Kali S.

Source: Pediatric Neurology, Volume 21, Number 5, November 1999 , pp. 809-813(5)

http://www.ingentaconnect.com/content/els/08878994/1999/00000021/00000005/art00100;jsessionid=4g96ls07h8ihb.alexandra?format=print

What is Jervell and Lange-Nielsen syndrome?

Jervell and Lange-Nielsen syndrome is a condition that causes profound hearing loss from birth and a disruption of the heart's normal rhythm (arrhythmia). This disorder is a form of long QT syndrome, which is a heart condition that causes the heart (cardiac) muscle to take longer than usual to recharge between beats. Beginning in early childhood, the irregular heartbeats increase the risk of fainting (syncope) and sudden death.
http://ghr.nlm.nih.gov/condition=jervellandlangenielsensyndrome

After sympathectomy, all other options are made ineffective

The relapse of Raynaud's phenomenon after surgically sufficient sympathectomy could not be treated by reserpine or alfa-adrenergic receptor blockers in two patients in whom this was tried.
http://www.ncbi.nlm.nih.gov/pubmed/6941602?dopt=Abstract
Acta Chir Scand Suppl. 1980;502:57-62.

Ultrastructural changes in the nerves innervating the cerebral artery after sympathectomy

Volume 109, Number 4 / December,1970
http://www.springerlink.com/content/l7213648355u2088/

Cold Hypersensitivity after Sympathectomy for Raynaud's Disease

Two patients with socially handicapping Raynaud's disease underwent bilateral upper thoracic sympathectomy. One to two days after the operation, both developed local hypersensitivity to cold in the form of a rebound. The cold hypersensitivity persisted in one of the patients, although complete degeneration of vasoconstrictor fibres was proven by absence of the sympathetic veno-arteriolar reflex after sympathectomy. Pre-operative sympathetic blockade could not predict the outcome of sympathectomy.
Scandinavian Cardiovascular Journal, Volume 14, Issue 1 1980 , pages 109 - 111