THE SKIN IS THE BIGGEST ORGANS THAT ALSO TAKES A ROLE IN THERMOREGULATION. THIS ROLE WILL BE DISABLED.
PARALYSIS OF THE SKIN ALSO MEANS A LACK OF GOOSE BUMPS FORMING IN THE AREA OF DENERVATION, RADIATING HEAT FROM THE BODY IN COLD WEATHER. THIS AREA WILL BE NOT EFFECTIVE IN HOT WEATHER, AS IT WILL BE UNABLE TO SWEAT, THUS THE BODY WILL BE UNABLE TO COOL OFF.
PATIENTS WEHO HAVE UNDERGONE SYMPATHECTOMY ARE IN GRAVE DANGER ONCE OVERHEATING, THEY BECOME MORE SENSITIVE AND VULNERABLE TO COLD AND HOT TEMPERATURES. WITH THE ADDITIONAL CIRCULATORY DISTURBANCE, REDUCED HEART RATE, UNSTABLE BLOOD PRESSURE AND EXTREME LOWED BODY SWEATING...ALL THIS AFTER THEY HAVE UNDERGONE A TREATMENT FOR BLUSHING...
ANHIDROSIS AFTER SYMPATHETOMY
Prediction: Thoracic sympathectomy will cause anhidrosis in the denerved area.
Empirical Status: Confirmed.
Anhidrosis
Sweat glands are controlled almost entirely via the sympathetic nervous system, and do not have parasympathetic innervation at all. Unlike most other sympathetic nerve terminals, the receptors in sweat glands are activated by acetylcholine, not norepinephrine. It is possible that sweat glands can be activated locally to a small degree by catecholamines in the blood, but for practical purposes sympathectomy renders sweat glands permanently non-functional in the denerved area. This dysfunction is called "anhidrosis".
Anhidrosis is considered dangerous, as we learn from the WebMD dictionary:
Anhidrosis: Not sweating. From the Greek an- meaning a lack of + hidros meaning sweat = lack of sweat. The inability to sweat may seem a blessing but it is not, since to sweat is to be able to stay cool. Anhidrosis creates a dangerous inability to tolerate heat. (WebMD dictionary)
In one clinical trial, ETS patients subjectively described the sensation of anhidrosis as “disturbing”.
“Patients undergoing T2-T4 resection often experience anhidrosis from the nipple line upwards which has been disturbing for several individuals.” (Fischel et al. 2003)
http://www.editthis.info/corposcindosis/Changes_to_Individual_Effectors,_part_2
TREATMENT NEEDED AFTER THE TREATMENT ENDED UP NOT BEING A TREATMENT ...
COMMUNICATIONS AND BRIEF REPORTS
Treatment of Unilateral Compensatory Sweating after Endoscopical Thoracic Sympathectomy for General Hyperhidrosis with Botulinum Toxin A
- FALK GEORGES BECHARA, MD * * Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany; ,
- MICHAEL SAND, MD * * Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany; ,
- GEORG MOUSSA, MD * * Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany; ,
- DANIEL SAND, BS † † Department of Physiological Science, University of California Los Angeles (UCLA), Los Angeles, California; ,
- PETER ALTMEYER, MD * * Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany; ,
- KLAUS HOFFMANN, MD * * Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany; and
- JOHANNES SCHMIDT, MD ‡ ‡ Department of Visceral Surgery, Lutherhaus Essen, University of Witten-Herdecke, Essen, Germany
BODY WEIGHT
Chemical Sympathectomy Alters Regulation of Body Weight
During Prolonged ICV Leptin Infusion
Robert L. Dobbins1, Lidia S. Szczepaniak1, Weiguo Zhang1 and J. Denis McGarry1,2
During Prolonged ICV Leptin Infusion
Robert L. Dobbins1, Lidia S. Szczepaniak1, Weiguo Zhang1 and J. Denis McGarry1,2
ABOUT LIPOLYSIS FOLLOWING SYMPATHECTOMY
Hormones in Muscular Activity
by Atko Viru - 1985 - Medical 121 ± 13 min).44 Consequently, following chemical sympathectomy the adrenal medulla is unable to ensure adequate lipolysis. ...
Limited preview - books.google.com/books?isbn=0849354943... Monckeberg's sclerosis after sympathetic denervation
Goebel FD, Fuessl HS.
Medial arterial calcification is frequently seen in diabetic patients with severe diabetic
neuropathy. Sixty patients (19 diabetic and 41 non-diabetic) were examined
radiologically for typical Monckeberg's sclerosis of feet arteries 6-8 years after uni- or
bilateral lumbar sympathectomy. Fifty-five out of 60 patients (92%) revealed medial
calcification. This calcification was observed in both feet of 93% of patients, who had
undergone bilateral operation. After unilateral sympathectomy the incidence of calcified
arteries on the side of operation was significantly higher than that on the contralateral
side (88% versus 18%, p less than 0.01). Although diabetic patients showed longer
stretches of calcification than non-diabetic subjects, the difference was not significant in
terms of incidence and length. Of 20 patients who had no evidence of calcinosis
pre-operatively, 11 developed medial calcification after unilateral operation exclusively
on the side of sympathectomy. In seven patients calcinosis was detected in both feet after
bilateral operation. In conclusion, sympathetic denervation is one of the causes of
Monckeberg's sclerosis regardless of diabetes mellitus.
Medial arterial calcification is frequently seen in diabetic patients with severe diabetic
neuropathy. Sixty patients (19 diabetic and 41 non-diabetic) were examined
radiologically for typical Monckeberg's sclerosis of feet arteries 6-8 years after uni- or
bilateral lumbar sympathectomy. Fifty-five out of 60 patients (92%) revealed medial
calcification. This calcification was observed in both feet of 93% of patients, who had
undergone bilateral operation. After unilateral sympathectomy the incidence of calcified
arteries on the side of operation was significantly higher than that on the contralateral
side (88% versus 18%, p less than 0.01). Although diabetic patients showed longer
stretches of calcification than non-diabetic subjects, the difference was not significant in
terms of incidence and length. Of 20 patients who had no evidence of calcinosis
pre-operatively, 11 developed medial calcification after unilateral operation exclusively
on the side of sympathectomy. In seven patients calcinosis was detected in both feet after
bilateral operation. In conclusion, sympathetic denervation is one of the causes of
Monckeberg's sclerosis regardless of diabetes mellitus.
Reduced baroreflex sensitivity is associated with increased vascular calcification and arterial stiffness
Reduced baroreflex sensitivity is associated with increased vascular calcification and arterial stiffness
Introduction. Vascular calcification is a critical determinant of cardiovascular morbidity and mortality in chronic haemodialysis (HD) patients. The pathophysiology underlying this observation remains obscure. Baroreceptor sensitivity (BRS) is important in the maintenance of an appropriate cardiovascular status both at rest and under the physiological stress of HD. BRS is determined by both the mechanical properties of the vascular wall, mediating the transfer of transmural pressure, and afferent and efferent autonomic function. We aimed to study the association between arterial structure, function and BRS in chronic HD patients.
Conclusion. The reduction in BRS and the resulting aberrant blood pressure response to the physiological stress and volume changes of HD may be important in the further understanding of the pathophysiology of the increased mortality in HD patients with vascular calcification.
Lindsay J. Chesterton1, Mhairi K. Sigrist1, Terence Bennett2, Maarten W. Taal1 and Christopher W. McIntyre
Introduction. Vascular calcification is a critical determinant of cardiovascular morbidity and mortality in chronic haemodialysis (HD) patients. The pathophysiology underlying this observation remains obscure. Baroreceptor sensitivity (BRS) is important in the maintenance of an appropriate cardiovascular status both at rest and under the physiological stress of HD. BRS is determined by both the mechanical properties of the vascular wall, mediating the transfer of transmural pressure, and afferent and efferent autonomic function. We aimed to study the association between arterial structure, function and BRS in chronic HD patients.
Conclusion. The reduction in BRS and the resulting aberrant blood pressure response to the physiological stress and volume changes of HD may be important in the further understanding of the pathophysiology of the increased mortality in HD patients with vascular calcification.
Lindsay J. Chesterton1, Mhairi K. Sigrist1, Terence Bennett2, Maarten W. Taal1 and Christopher W. McIntyre
In a person who had a sympathectomy, the sympathetic component of the baroreceptor mechanism is absent
The baroreceptor reflex is only a short-term regulator of blood pressure because the receptors adapt by raising the threshold and lowering discharge rate.
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.
Heart Physiology II
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
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.
Heart Physiology II
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
reduction of jejunal mucosal perfusion following sympathectomy
Abstract
Reduction of central blood volume elicits a peripheral vasoconstrictor reflex in various tissues including skin, skeletal muscle and thePredicting CS?
The mechanism of the so-called Compensatory Sweating is still unclear, and there are no ways to predict who will bit hit harder.
Some surgeons tell their patients that it happens mostly to men, who are overweight and had a heavy sweating prior to surgery.
This has never been proven, and my experience with people who underwent the surgery and have the debilitating CS does not indicate any group that would be more likely to be affected.
Also: these statistics are unreliable. There has been no independent study the examine the severity or extent of the CS. Many questions are not asked, so that they will not tarnish the results. These statistics are collected and questions formulated by the surgeons who offer the surgery. It would be reasonable to assume that they will look for a confirmation of the effectiveness of the operation....otherwise they would not do the surgery....
Some surgeons tell their patients that it happens mostly to men, who are overweight and had a heavy sweating prior to surgery.
This has never been proven, and my experience with people who underwent the surgery and have the debilitating CS does not indicate any group that would be more likely to be affected.
Also: these statistics are unreliable. There has been no independent study the examine the severity or extent of the CS. Many questions are not asked, so that they will not tarnish the results. These statistics are collected and questions formulated by the surgeons who offer the surgery. It would be reasonable to assume that they will look for a confirmation of the effectiveness of the operation....otherwise they would not do the surgery....
15% regretted the operation.
Evaluation of compensatory sweating after bilateral thoracoscopic sympathectomy for palmar hyperhidrosis.
Department of Surgery "A," Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
The study is a retrospective review of 60 patients undergoing bilateral T2-T3 thoracoscopic sympathectomy for palmar hyperhidrosis in our department between 1997 and 2003. The study was based on a telephone questionnaire and medical chart review. Forty patients (67%) replied to the questionnaire and were included in the study. Postoperative complications, therapeutic results, patient satisfaction, and the severity of compensatory sweating (CS) were assessed. In all patients both palms were dry at the end of surgery. Postoperative complications included permanent unilateral Horner syndrome, wound infection, and residual pneumothorax resolving after thoracal drainage, in one patient each. CS with different severity occurred in 35 patients (87.5%). Six patients (15%) regretted undergoing the operation due to the extent and severity of the CS seriously affecting their quality of life. Thoracoscopic sympathectomy is a simple procedure with a high success rate. However, CS is a serious complication and a significant number of patients may regret undergoing the operation; a careful selection of patients and comprehensive explanation are advisable.
Melatonin changes after sympathectomy
Bruce J, Tamarkin L, Riedel C, Markey S, Oldfield E.
Sequential cerebrospinal fluid and plasma sampling in
humans: 24-hour melatonin measurements in normal
subjects and after peripheral sympathectomy. English.
72. 1991:819-23.
Brismar K, Mogensen L, Wetterberg L.
Depressed
melatonin secretion in patients with nightmares due to
beta-adrenoceptor blocking drugs. English. 221.
1987:155-8.
Evidence suggests a link between endogenous melatonin and the sleep cycle
• There is evidence of a link between endogenous melatonin and the temperature rhythm.
Sequential cerebrospinal fluid and plasma sampling in
humans: 24-hour melatonin measurements in normal
subjects and after peripheral sympathectomy. English.
72. 1991:819-23.
Brismar K, Mogensen L, Wetterberg L.
Depressed
melatonin secretion in patients with nightmares due to
beta-adrenoceptor blocking drugs. English. 221.
1987:155-8.
Evidence suggests a link between endogenous melatonin and the sleep cycle
• There is evidence of a link between endogenous melatonin and the temperature rhythm.
nerve blocks as a treatment for Herpes Zoster...
Management of herpes zoster (shingles) and postherpetic neuralgia
Robert W JohnsonPain Management Clinic, Level 4, Bristol Royal Infirmary, Bristol, BS2 8HW, UK.
The Cancer Patient with Chronic Pain Due To Herpes Zoster
... were mild and tolerable and consisted primarily of somnolence and dizziness. ... Peripheral neurectomy, cordotomy, dorsal rhizotomy, sympathectomy, ...www.current-reports.com/
Insulin hypersensitivity produced by sympathectomy
Insulin hypersensitivity has been undeniably produced by hypophysectomy, by adrenalectomy, by sympathectomy, by spinal cord lesions, and by hypothalamic lesions.
THE HYPOTHALAMUS: A REVIEW OF THE
EXPERIMENTAL DATA
W. R. Ingram
THE HYPOTHALAMUS: A REVIEW OF THE
EXPERIMENTAL DATA
W. R. Ingram
blood pressure response abolished by sympathectomy
The emotional leucocytosis observed in dogs has been claimed to be neurogenic in origin, since sympathectomy abolished the rise in leucocyte count (Garrey & Bryan, 19 3 5).
