Alterations of the Three-Phase Bone Scan After Sympathectomy
The data demonstrated that alterations in TPBS after sympathectomy are identical to those reported in early RSD and these alterations bear no relationship to the success of sympathectomy regarding pain relief. The mechanisms underlying alterations of TPBS as well as the potential mechanisms of sympathectomy failures are discussed.
Clinical Journal of Pain. 10(2):146-155, June 1994
Clinical Journal of Pain. 10(2):146-155, June 1994
sympathectomy is based on poor quality evidence, uncontrolled studies and personal experience
The practice of surgical and chemical sympathectomy is based on poor quality evidence, uncontrolled studies and personal experience. Furthermore, complications of the procedure may be significant, in terms of both worsening the pain or producing a new pain syndrome; and abnormal forms of sweating (compensatory hyperhidrosis and pathological gustatory sweating). Therefore, more clinical trials of sympathectomy are required to establish the overall effectiveness and potential risks of this procedure.
Cochrane Database Syst Rev. 2003;(2):CD002918.
Cochrane Database Syst Rev. 2003;(2):CD002918.
Painful sweating after nerve sprouting
The authors propose that after destruction of cutaneous nerves, aberrant regenerant sprouting innervates sweat glands, producing gustatory sweating as in auriculotemporal syndrome (Frey syndrome), and innervates nociceptors, producing pain.
http://www.neurology.org/cgi/content/abstract/63/8/1471
http://www.neurology.org/cgi/content/abstract/63/8/1471
Sexual function after bilateral lumbar sympathectomy
In patients who had only bilateral sympathectomy, these complications occurred in 24% and mainly consisted of ejaculation disturbances. Only three patients became impotent, each having had aortic surgery.
http://www.ncbi.nlm.nih.gov/pubmed/7364866
http://www.ncbi.nlm.nih.gov/pubmed/7364866
Sympathectomy as a cure for psychiatric mischief...
Of those I havemet, however, some have been supposed to be subject to deep psychiatric
mischief, none has benefited from psychiatric treatment, and all have been
cured by sympathectomy. Furthermore it must be noted as a matter of
special interest that the cure is permanent, and the trouble does not recur
even in patients who show evidence of some return of sympathetic function.
SOME UNSOLVED PROBLEMS IN THE SURGERY OF THE
SYMPATHETIC NERVOUS SYSTEM
Bradshaw Lecture delivered at the Royal College of Surgeons of England
on 11th June, 1953
by
Professor Sir James Paterson Ross, K.C.V.O., F.R.C.S.
Vice-President, Royal College of Surgeons of England