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Autonomic neuropathy

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Contents of this page:

Illustrations

Autonomic Nerves
Autonomic Nerves
Central nervous system
Central nervous system

Alternative Names    Return to top

Neuropathy - autonomic

Definition    Return to top

Autonomic neuropathy is a group of symptoms caused by damage to nerves that regulate blood pressure, heart rate, bowel and bladder emptying, digestion, and other body functions.

Causes    Return to top

Autonomic neuropathy is a form of peripheral neuropathy. Autonomic neuropathy is a group of symptoms, not a specific disease. There are many causes.

Autonomic neuropathy involves damage to the nerves that run through a part of the peripheral nervous system. The peripheral nervous system includes the nerves used for communication to and from the brain and spinal cord (central nervous system) and all other parts of the body, including the internal organs, muscles, skin, and blood vessels.

Damage to the autonomic nerves causes abnormal or decreased function of the areas connected to the problem nerve. For example, damage to the nerves of the gastrointestinal tract makes it harder to move food during digestion (decreased gastric motility).

Damage to the nerves supplying blood vessels causes problems with blood pressure and body temperature.

Autonomic neuropathy is associated with the following:

Symptoms    Return to top

Exams and Tests    Return to top

Inspection of the abdomen may show distention, and listening to the abdomen with a stethoscope (auscultation) may show abnormal sounds indicating decreased gastric motility.

An eye examination may show sluggish pupil reaction. Examination by touch (palpation) or tapping (percussion) may indicate a distended bladder. Blood pressure examination may show a decrease upon standing (postural hypotension).

Occasionally, other symptoms may indicate disturbed functioning of the autonomic nervous system, including high blood pressure, rapid or slow heart rate, irregular heart rhythms, excessive sweating, difficulty swallowing, or other symptoms.

Special measurements of sweating and heart rate are called "autonomic testing" and can assist in diagnosis and treatment.

Other tests for autonomic neuropathy are guided by the suspected cause of the disorder, as suggested by the history, symptoms, and pattern of symptom development.

Treatment    Return to top

Treatment is supportive and may need to be long-term. Several treatments may be attempted before a successful one is found.

The use of elastic stockings and sleeping with the head elevated may reduce postural hypotension. Fludrocortisone or similar medications may be beneficial in reducing postural hypotension for some people. In severe cases, Proamatine may help prevent a drop in blood pressure when standing.

Medications that increase gastric motility (such as Reglan), small, frequent meals, sleeping with the head raised up, or other measures may be used to treat reduced gastric motility.

Impotence, diarrhea, constipation, bladder problems, and other symptoms are treated as appropriate. These symptoms may respond poorly to treatment.

Outlook (Prognosis)    Return to top

The outcome varies. If the cause can be identified and treated, there is a chance that the nerves associated with autonomic neuropathy may repair or regenerate. The symptoms may improve with treatment, or they may persist or worsen despite treatment.

Most symptoms of autonomic neuropathy are uncomfortable but they are seldom life threatening.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call for an appointment with your health care provider if symptoms of autonomic neuropathy occur. Early diagnosis and treatment increases the likelihood of controlling symptoms.

Prevention    Return to top

Prevention or control of disorders that may be associated with autonomic neuropathy may reduce the risk. For example, diabetics should control blood sugar levels closely. Alcoholics should stop drinking.

Update Date: 9/10/2006

Updated by: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.

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