Posted by ccf neuro M.D.* on November 08, 1997 at 00:40:15:

In Reply to: Compensatory Hyperhidrosis posted by Francis Choy on October 15, 1997 at 05:36:50:

6 mths ago, I underwent T-2 and T-3 sympathectomy to cure my palmar and axillae hyperhydrosis problem. My hands and axillae are now dry. But as a result of the surgery, my body above the nipples now does not sweat. And when the temperature gets warm (above 80F), sweat pours from other parts of my body where the sympathectic nerves are intact. This compensatory sweating is really troublesome. My compensatory sweating is on my abdomen, lower back and legs. Would the compensatory sweating improve with time and how long after surgery will this happen? Also, would my chest area start to sweat again? What is the mechanism of compensatory sweating? Are there any means to reduce the compensatory sweating either through medication or further surgery? I understand that Cardizem and Serazone on top of anti-colinergics may be prescribed to help alleviate the effects of severe compensatory sweating. Should I consider lumbar sympathectomy to stop the perspiration on my legs? Appreciate your advise. Thank you. Francis Choy.
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Francis,

Whenever your hypothalamus, the part of the brain that regulates sweating, perceives that your body temparature is too hot, it will cause you to sweat in order to dissipate (lose) heat. If you have had your cervical and upper thoraccic sympathetic nerves destroyed to eliminate sweating in your axillae and palms, the hypothalamus and sympathetic nervous system have nowhere else to turn except the other parts of your body when they decide you need to sweat. Profuse sweating in over 80 degree weather is not unusual or even pathologic---- some people just sweat alot more than others, and you may be one of them. Obesity is the prime risk factor, and there are familial tendencies as well. I would not suggest destruction of any more of your sympathetic nervous system, as failure to dissipate heat by doing so could result in your having a heat stroke, and could also result in a dangerous reduction in your body's ability to regulate blood pressure in response to changes in body position, causing you to frequently get lightheaded or even faint when you stand up from a lying or sitting position. I'd definitely suggest considering leaving well enough alone and not talk yourself into a potentially dangerous "solution" for your perceived "problem". Anticholinergic medications will decrease sweating but have many other unwanted side effects, and again cause you to retain heat and may be dangerous if it is hot. Information provided in the forum is intended for general informational purposes only. The actual diagnosis and treatment of your specific medical condition should be strictly in conjunction with your treating physicians.