الفهرس 
ANATOMY OF AUTONOMIC NERVOUS SYSTEMOnly 14 pages are availabe for public view
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Abstract
Hyperhydrosis is a pathological condition in which sweating occurs in excess of that required for thermoregulation. It can be very distressing and a source of intense embarrassment, interfering with social and work commitments. It may be primary with no obvious underlying cause, or secondary to a variety of neurological or systemic diseases such as thyrotoxicosis, pheochromocytoma, T.B. and lymphomas.
Hyperhydrosis affects the skin of the whole body but its clinical effects are seen in areas with a high density of eccrine sweat glands (palms, axillae and soles). The incidence of palmar hyperhydrosis may be as high as 1% and positive family history can be obtained in 30-50% of cases.
Sympathectomy is currently the most acceptable surgical treatment for disabling upper limb hyperhydrosis by resecting or ablating with diathermy the 2nd, 3rd and possibly 4th thoracic sympathetic ganglia. The approach may either be supraclavicular or transaxillary. The results of a successful thoracic sympathectomy are predictable with the hands being rendered completely anhydrotic and the axillae being dried by a factor of 80%.
The complications of thoracoscopic sympathectomy include compensatory sweating , gustatory sweating , phantom sweating , a transient increase in upper limb sweating , facial anhydrosis , ptosis , meiosis , excessively dry skin of the hands and recurrence of hyperhydrosis . Pulmonary complications include dyspnea, pneumothorax , haematothorax , pleural effusion and very rare cases of intraoperative cardiac arrest (Lin and Hauang ,1994 ).
Compensatory sweating is one of the most troublesome and commonly noted complications. Its incidence following thoracoscopic sympathectomy varies from 24 to 81% ( Hedoman, 1994 ) .
In this study the changes in the distribution and extent of sweating following a T2-3 and possibly T4 thoracoscopic sympathectomy was defined.
We noticed that there was high incidence of compensatory sweating in the back of the trunk and with lower degree in the lower limbs and abdomen and the lowest parts which were affected with compensatory sweating were the chest wall and feet. These results are more or less the same as the results detected in the other recent studies on this subject.
So we must inform the patients preoperatively about the compensatory sweating and its distribution although it was mild to moderate mostly in all patients and improved in few months and the satisfactory rate about the results of the operation in this study was very high (about 97%) .