Cervical Sympathetic Neuralgia Arising From a Schwannoma


  • William P. Cheshire MD,

  • John A. Odell MD,

  • Timothy A. Woodward MD,

  • Robert E. Wharen Jr MD

  • From the Department of Neurology (Dr. Cheshire); Transplant Center (Dr. Odell); Division of Gastroenterology, Department of Medicine (Dr. Woodward); Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA (Dr. Wharen).

Address all correspondence to Dr. William Cheshire, Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.


We describe an unusual case of neuropathic pain of the left face and shoulder accompanied by ipsilateral hyperhidrosis caused by a schwannoma of the cervical sympathetic chain. Additional signs of associated sympathetic hyperactivity included left-sided lacrimation, conjunctival injection, and nasal congestion. Autonomic testing demonstrated signs of increased vasomotor and sudomotor activity in the left palm. The pain was refractory to analgesic and antimigraine medications but resolved following surgical resection of the T2 schwannoma.