Drummond P D, Lance J W
Brain. 1987 Jun;110 ( Pt 3):793-803. doi: 10.1093/brain/110.3.793.
Sweating and flushing of the forehead and cheeks in response to body heating, embarrassment and strong gustatory stimulation were investigated in 23 patients with a unilateral lesion in the sympathetic pathway to the face. A lesion anywhere along this pathway impaired thermoregulatory sweating and flushing on the denervated side of the forehead in most patients and also of the cheek in some cases. Emotional sweating was also diminished on the denervated side of the forehead irrespective of the site of lesion, but impairment of emotional vasodilatation was noted only with peripheral (second or third neuron) lesions. These findings suggest that sympathetic vasodilator fibres accompany vasoconstrictor and sudomotor fibres through conventional sympathetic pathways to the face. Gustatory sweating and flushing were symmetrical in most patients but flushing was more marked on the denervated side in three cases. Gustatory sweating was accompanied by flushing on the denervated side of the forehead in one patient following section of the T2 and T3 roots. It is concluded that the cervical sympathetic outflow is the main pathway for thermoregulatory flushing and emotional blushing and that diminution or absence of such vasodilator reactions is a usual component of Horner's syndrome unless the responsible lesion is confined to the first thoracic root. Gustatory vasodilatation and sweating is preserved and becomes exaggerated in some instances.
对23例面部交感神经通路单侧病变的患者，研究了其在身体受热、尴尬及强烈味觉刺激时前额和脸颊的出汗及潮红情况。该通路沿线任何部位的病变，在大多数患者中会损害前额去神经侧的体温调节性出汗和潮红，在某些情况下也会损害脸颊的体温调节性出汗和潮红。无论病变部位如何，前额去神经侧的情绪性出汗也会减少，但仅在外周（第二或第三神经元）病变时会出现情绪性血管舒张受损。这些发现提示，交感舒血管纤维与血管收缩纤维及泌汗纤维一同经传统交感神经通路至面部。大多数患者的味觉性出汗和潮红是对称的，但有3例患者去神经侧的潮红更明显。1例患者在T2和T3神经根切断后，前额去神经侧的味觉性出汗伴有潮红。结论是，颈交感神经传出是体温调节性潮红和情绪性脸红的主要通路，除非责任病变局限于第一胸神经根，否则这种血管舒张反应减弱或缺失是霍纳综合征的常见表现。味觉性血管舒张和出汗得以保留，在某些情况下会变得更加明显。
