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Alternative namesNeuropathy - autonomic
DefinitionAutonomic neuropathy is a group of symptoms caused by damage to nerves supplying the internal body structures that regulate functions such as blood pressure, heart rate, bowel and bladder emptying, and digestion.
Causes, incidence, and risk factors
Autonomic neuropathy is a form of peripheral neuropathy affecting the autonomic portion of the peripheral nervous system.
Autonomic neuropathy involves damage to the nerves supplying the autonomic portion of the peripheral nervous system, which is the portion that supplies the internal organs, blood vessels, and other areas not under voluntary (purposeful) control.
Damage to the nerves supplying blood vessels causes problems with regulation of blood pressure and body temperature; dilation of skin capillaries is used to dissipate heat from the body. Damage to other structures causes similar dysfunction.
Signs and tests
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.
TreatmentTreatment is supportive. Treatment may need to be chronic and prolonged, and the response to treatment varies. Several treatments may be attempted before a successful treatment 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.
Medications that increase gastric motility (such as Reglan); small, frequent meals; sleeping with the head elevated; or other measures may be used to treat reduced gastric motility.
Manual expression of urine (a technique in which the hands are used to compress the bladder), intermittent catheterization, or medications such as bethanechol may be necessary to treat bladder dysfunction.
Impotence , diarrhea , constipation , or other symptoms are treated as appropriate. These symptoms may respond poorly to treatment.
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.
Calling your health care providerCall for an appointment with your health care provider if symptoms of autonomic neuropathy occur. Early diagnosis and treatment increases the likelihood of controlling symptoms.
PreventionPrevention 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: 7/28/2002Elaine T. Kiriakopoulos, M.D., MSc, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT