"Sympathectomy is a technique about which we have limited knowledge, applied to disorders about which we have little understanding." Associate Professor Robert Boas, Faculty of Pain Medicine of the Australasian College of Anaesthetists and the Royal College of Anaesthetists

http://www.pfizer.no/templates/Page____886.aspx

Sympathectomy a psychosurgery?

Financial Review - News Store: "It's not unusual to hear people who have undergone sympathectomies describe themselves as feeling emotionally "colder" than before. Among psychologists and neurologists alike there is concern, but no evidence, that the procedure limits alertness and arousal as well as fear, and might affect memory, empathy and mental performance. Professor Ronald Rapee, the director of the Centre of Emotional Health at Sydney's Macquarie University, says he's counselled several people who complain of feeling "robot-like" in the long-term wake of the operation. "They're happy they no longer blush, but they miss the highs and lows they used to feel.""



'via Blog this'

Dr. Telaranta treating fear, stuttering, stage fright, blushing with sympathectomy. Is ETS a psychosurgery?

Dr. Telaranta | Blog by Dr. Telaranta: "As a treatment, sympathetic blocking could be effective. Fortunately one can test whether it’ll have an effect, to a pretty high level of certainty, by first administering a temporary block t. Sympathetic block is usually effective in reducing all types of fear, why not also in reducing the fear of stuttering.

Sympathetic block typically has the highest likelihood of effective results on both schizophrenia and tremor when fear or anxiety plays a significant part in the onset of symptoms. It is also very effective in treating social phobia, stage fright and blushing. A stage fright-like fear of public presentations is likely common amongst those who stutter."



http://www.sympatix.fi/blog/?lang=en_

sympathectomy, by chemical or surgical means, is based on such anecdotal observation and small case studies which have failed to stand up to scientific scrutiny

Clinical trials do exist and their inability to demonstrate effectiveness suggests an obvious conclusion: the argument for sympathectomy, by chemical or surgical means, is based on such anecdotal observation and small case studies which have failed to stand up to scientific scrutiny. To date there are no reproducible, blinded, randomized studies utilizing control populations which have demonstrated a benefit to sympathetic blockade in CRPS.

DISABILITY MEDICINE, The Official Periodical of the American Board of Independent Examiners,
Vol. 5 No. 3-4 July - December 2005
www.abime.org/documents/Journalv5n34.pdf

Following a peripheral nerve injury, a sterile inflammation develops in sympathetic and dorsal root ganglia

Following a peripheral nerve injury, a sterile inflammation develops in sympathetic and dorsal root ganglia (DRGs) with axons that project in the damaged nerve trunk. Macrophages and T-lymphocytes invade these ganglia where they are believed to release cytokines that lead to hyperexcitability and ectopic discharge, possibly contributing to neuropathic pain. Here, we examined the role of the sympathetic innervation in the inflammation of L5 DRGs of Wistar rats following transection of the sciatic nerve, comparing the effects of specific surgical interventions 10-14days prior to the nerve lesion with those of chronic administration of adrenoceptor antagonists. Immunohistochemistry was used to define the invading immune cell populations 7days after sciatic transection. Removal of sympathetic activity in the hind limb by transecting the preganglionic input to the relevant lumbar sympathetic ganglia (ipsi- or bilateral decentralization) or by ipsilateral removal of these ganglia with degeneration of postganglionic axons (denervation), caused less DRG inflammation than occurred after a sham sympathectomy. By contrast, denervation of the lymph node draining the lesion site potentiated T-cell influx. Systemic treatment with antagonists of α1-adrenoceptors (prazosin) or β-adrenoceptors (propranolol) led to opposite but unexpected effects on infiltration of DRGs after sciatic transection. Prazosin potentiated the influx of macrophages and CD4+ T-lymphocytes whereas propranolol tended to reduce immune cell invasion. These data are hard to reconcile with many in vitro studies in which catecholamines acting mainly via β2-adrenoceptors have inhibited the activation and proliferation of immune cells following an inflammatory challenge.
 2013 Dec 23.
http://www.ncbi.nlm.nih.gov/pubmed/24418114

Surgical sympathectomy is rarely performed and its use remains controversial

Although improved in some, persistent or recurrent symptoms were present in all patients after six months postoperatively. Increased sensitivity of digital vessels to circulating catecholamines, nerve fiber regeneration or incomplete sympathectomy have been postulated to lead to recurrence. Five patients developed Horner's syndrome postoperatively. A portion of the stellate ganglion was intentionally resected in 3 of the 5 patients.
http://www.ncbi.nlm.nih.gov/pubmed/8370999

prolongation of the isometric (tension) period (TP) of the left ventricle occurred in the majority (72 per cent) of all cases after sympathectomy

The prolongation of the isometric (tension) period (TP) of the left ventricle which occurred in the majority (72 per cent) of all cases after unilateral or bilateral transthoracic sympathectomy (without or with unilateral or bilateral transthoracic splanchnicotomy) indicates a diminution of inotropic cardiac action. It can be assumed to correspond to the cholinergic (vagal) preponderance which results from a partial or complete sympathetic denervation of the heart. Reduction of the pulse pressure oc-

curred in 56 per cent of the cases, probably due to the same mechanism.

www.chestjournal.org/content/38/4/423.full.pdfby W RAAB - 1960