Fifty-six consecutive patients who subsequently underwent ninety-six lumbar sympathectomies were studied prospectively with regard to the development of postoperative pain. Pain after operation was observed in thirty-four extremities by twenty-five of the patients (35 per cent). It began abruptly an average of twelve days after operation and was often accentuated nocturnally. The pain was almost always described as a deep, dull ache and persisted two to three weeks before spontaneously remitting. Postsympathectomy pain of such severity that parenteral narcotics afforded no relief developed in two of these fifty-six patients and in nine additional patients. Treatment with carbamazepine produced dramatic reduction in the intensity of pain in seven of these nine patients within twenty-four hours after the institution of therapy. Two patients were given intravenous diphenylhydantoin and both experienced immediate relief of pain. The mechanisms of the syndrome and of the action of these drugs are uncertain.
Systemic therapy with glycopyrrolate or clonidine can be effective for HH. Nearly two-thirds responded to therapy, and less than a quarter had treatment-limiting adverse effects, all of which were self-limited and nonserious
J Am Acad Dermatol. 2012 Mar;66(3):387-92. doi: 10.1016/j.jaad.2011.01.023. Epub 2011 Aug 4.
http://www.ncbi.nlm.nih.gov/pubmed/21820204
A randomized placebo-controlled trial of oxybutynin for the initial treatment of palmar and axillary hyperhidrosis
Palmar and axillary hyperhidrosis improved in >70% of the patients, and 47.8% of those presented great improvement. Plantar hyperhidrosis improved in >90% of the patients. Most patients (65.2%) showed improvements in their quality of life. The side effects were minor, with dry mouth being the most frequent (47.8%).
Journal of Vascular Surgery, Volume 55, Issue 6, June 2012, Pages 1696-1700
Long-term efficiency? 40% affirmed they would ask for the operation if it were to be redone, 53% recurrence
At an average 12 years after surgery, 47% of patients were satisfied with the treatment results, 40% were disappointed.
53% complaining about a decent to moderate recurrence of hand sweating and compensatory and gustatory sweating were observed in 9 (60%) and 5 (33%) patients, respectively.
Interact CardioVasc Thorac Surg (2009) 8 (1): 54-57.
53% complaining about a decent to moderate recurrence of hand sweating and compensatory and gustatory sweating were observed in 9 (60%) and 5 (33%) patients, respectively.
Only 56% would recommend thoracoscopic sympathectomy to others with hyperhydrosis
http://www.ncbi.nlm.nih.gov/pubmed/21539945
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