Compensatory hyperhidrosis

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Compensatory hyperhidrosis is the production of excessive sweat caused by the brain perceiving the body temperature as being too high. The sweating is induced to reduce body heat. Excessive sweating due to nervousness, anger, previous trauma or fear is called hyperhidrosis.

Compensatory Hyperhidrosis is the most often mentioned side-effect of Endoscopic thoracic sympathectomy. It is an abnormal sweating (below the level of the sympathetic chain disruption). Some of the literature refers to it as 'rebound' or 'reflex hyperhidrosis'.

The term 'compensatory' is largely inappropriate, as it indicates that there is a 'compensatory mechanism' that takes effect after sympathectomy. Surgeons offering this elective procedure will often make such claims on their websites, but there is no study to support it. The only study evaluating the total body sweat prior and post sympathectomy concluded that patients sweat more after the surgery.

This "Reflex" sweating can be tolerable for some patients, but there are many who end up with disabling sweating that requires them to change their clothes several times during the day.

Following surgery for axillary (armpit), palmar (palm) hyperhidrosis and blushing, the body sweats excessively at untreated areas, most commonly the lower back and trunk. The upper part of the body, above the sympathetic chain transection, the body becomes anhidriotic, where the patient is unable to sweat or cool down, which further compromises the body's thermoregulation and exacerbates the "Compensatory Hyperhidrosis. This phenomena is part of the autonomic dysregulation, a complex disorder experienced by patients post sympathectomy.

Gustatory sweating or Frey's syndrome is another side effect of this surgery. Gustatory Sweating is brought on while eating, thinking or talking about food that produce a strong salivary stimulus. It is thought that autonomous fibres to salivary glands have become connected in error with the sweat glands when they become reconnected [2]after nerve regeneration. Apart from sweating in the anihidriotic area of the body, it can produce goosebumps and drop of body temperature while eating.

External links

• Hyperhidrosis treatments, Causes and Information
• PubMed citation - Gustatory side effects after thoracoscopic sympathectomy.

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