Autonomic Neuropathy Causes, Symptoms, Diagnosis and Treatment

What Is Autonomic Neuropathy?

Autonomic neuropathy occurs when the nerves that control involuntary bodily functions are damaged.
The nerve damage interferes with the messages sent between the brain and other organs and areas of the autonomic nervous system, such as the heart, blood vessels and sweat glands.
Autonomic neuropathy may be experienced in a number of ways, depending on the organ system involved, for example difficulty adapting to changes in posture, or digestive symptoms.
. Symptomatic treatment is available for many symptoms associated with autonomic neuropathy, and some disease processes can be treated directly.

Causes Of Autonomic Neuropathy:

Autonomic neuropathy may occur due to inherited or degenerative neurologic diseases or injury of the autonomic nervous system from an acquired disorder.
Side effects of drugs can cause abnormalities in the function of the autonomic nervous system, producing an iatrogenic form of autonomic neuropathy.

Common causes include:

Heavy metal poisoning
    Autoimmune disorders
   Sjögren’s syndrome
   Lupus sarcoidosis
   Anti-NMDA receptor encephalitis
Diabetes mellitus
Multiple sclerosis
Parkinson’s disease
HIV and AIDS
    Hereditary disorders
   familial dysautonomia
   Ehlers-Danlos syndrome
Pure autonomic failure
Amyloidosis
Botulism
Chronic alcohol misuse
    Some bacterial infections
   Lyme disease
   tuberculosis
   Helicobacter pylori
Spinal cord injury
Surgery or injury involving the nerves
Physical trauma or injury
Closed brain injury caused by asphyxiation, poisoning or encephalitis

The following factors increase the likelihood of developing autonomic neuropathy:

Diabetes.
    Other diseases
   Amyloidosis
   Porphyria
   hypothyroidism
   cancer

Symptoms Of Autonomic Neuropathy:

The symptoms of dysautonomia are numerous and vary widely from person to person depending on the nerves affected and underlying cause. They develop gradually over years.

Signs and symptoms include:

Excessive fatigue
Excessive thirst (polydipsia)
Lightheadedness or dizziness, often associated with orthostatic hypotension (abnormally low blood pressure on standing), sometimes resulting in syncope (fainting)
Rapid heart rate or slow heart rate
Blood pressure fluctuations
Difficulty with breathing or swallowing
Shortness of breath with activity or exercise
Distension of the abdomen
Mydriasis (abnormal dilation of the pupils) leading to blurry vision
Urinary incontinence or neurogenic bladder dysfunction
Gastroparesis (delayed gastric emptying) with associated nausea, acid reflux and vomiting
Constipation
Excessive sweating or lack of sweating (anhydrosis)
Heat intolerance brought on with activity and exercise
Sexual problems including erectile dysfunction in men and vaginal dryness and orgasmic difficulties in women

Diagnosis Of Autonomic Neuropathy:

The following tests are conducted in order to diagnose autonomic neuropathy:

Valsalva maneuver
Tilt table test
Gastric emptying tests
Quantitative sudomotor axon reflex test (QSART)
Thermoregulatory sweat test
Urodynamic testing
Small fiber neuropathy biopsy
Endocrine testing

Treatment Of Autonomic Neuropathy:

There is no cure for autonomic neuropathy.

However, the following treatment options may help in relieving symptoms:

    Drugs can be used to treat an assortment of symptoms with varying degrees of success
   fludrocortisone
   midodrine
   ephedrine
   SSRIs
   Anticonvulsants
    Combating orthostatic intolerance
   Elevation of the head of the bed
   frequent small meals
   a high-salt diet
   fluid intake
   Compression stockings.
Proton-pump inhibitors
H2 receptor antagonists
cardiac ablation,
balloon angioplasty procedure
Dysautonomia secondary to autoimmune diseases or multiple sclerosis (MS) can often improve if the underlying disorder is diagnosed and therapy targeted for the underlying disorder is successful.
Immunosuppressive treatments