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Autonomic neuropathy is a group of symptoms that occur when there is damage to the nerves that regulate blood pressure, heart rate, bowel and bladder emptying, digestion, and other body functions.
Alternative NamesNeuropathy - autonomic
Causes, incidence, and risk factorsAutonomic neuropathy is a form of peripheral neuropathy. It 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 affects the function of 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).
Autonomic neuropathy affects the nerves that regulate vital functions, including the heart muscle and smooth muscles.
Damage to the nerves supplying blood vessels causes problems with blood pressureand body temperature.
Autonomic neuropathy is associated with the following:
- Alcoholic neuropathy
- Diabetic neuropathy
- Disorders involving scarring and hardening (sclerosis) tissues
- Guillain Barre syndrome or other diseases that inflame nerves
- HIV and AIDS
- Inherited nerve disorders
- Parkinson's disease
- Surgery or injury involving the nerves
- Use of anticholinergic medications
Symptoms vary depending on the nerves affected. They usually develop gradually over years.
Symptoms may include:
Digestive tract
- Constipation
- Diarrhea
- Feeling full after only a few bites (early satiety)
- Nausea after eating
- Swollen abdomen
- Unintentional loss of more than 5% of body weight
- Vomiting of undigested food
Heart
- Blood pressure changes with position
- Dizziness that occurs when standing up
Urinary tract
- Difficulty beginning to urinate
- Feeling of incomplete bladder emptying
- Urinary incontinence (overflow incontinence)
Other symptoms
- Abnormal sweating
- Fainting
- Heat intolerance, induced by exercise
- Male impotence
A medical history and general physical exam are critical. A brain and nervous system (neurological) examination may show evidence of injury to other nerves. However, it is very difficult to directly test for autonomic nerve damage.
Signs of autonomic neuropathy include:
- Abnormal sounds in the abdomen, indicating decreased gastric movement (motility)
- Decrease of blood pressure upon standing up (postural hypotension)
- Sluggish pupil reaction in the eye
- Swollen (distended) abdomen
- Swollen (distended) bladder
Occasionally, other symptoms may indicate a problem in the function of the autonomic nervous system, including:
- Difficulty swallowing
- Excessive sweating
- Irregular heart rhythms
- High blood pressure
- Rapid or slow heart rate
Special measurements of sweating and heart rate are called "autonomic testing" and can assist in diagnosis and treatment.
Other tests include:
- Measurement of blood pressure lying down, sitting, and standing
- Measurement of changes in heart rate
- Upper GI
- Esophagogastroduodenoscopy (EGD)
- Isotope study
- Voiding cystourethrogram (VCUG) or other tests of bladder function
Other tests for autonomic neuropathy are based on the suspected cause of the disorder, as suggested by the history, symptoms, and the way symptoms developed.
TreatmentTreatment is supportive and may need to be long-term. Several treatments may be attempted before a successful one is found.
Various strategies may be used to reduce symptoms in the feet, legs, and arms. These include:
- Florinef and salt tablets to increase fluid volume in blood vessels
- Fludrocortisone or similar medications to reduce postural hypotension
- Medications to help with salt and fluid retention
- Proamatine to prevent a drop in blood pressure when standing
- Sleeping with the head raised
- Use of elastic stockings
Treatments for reduced gastric motility include:
- Medications that increase gastric motility (such as Reglan)
- Sleeping with the head raised
- Small, frequent meals
Diarrhea, constipation, bladder problems, and other symptoms are treated as appropriate. These symptoms may respond poorly to treatment. Drugs that block bladder contractions may be used to help with urinary control problems.
Phosphodiesterase type 5 (PDE-5) drugs, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are safe and effective for treating impotence in patients with Diabetes.
Expectations (prognosis)The outcome varies. If the cause can be found and treated, there is a chance that the nerves may repair or regenerate. The symptoms may improve with treatment, or they may continue or get worse, even with treatment.
Most symptoms of autonomic neuropathy are uncomfortable, but they are rarely life threatening.
Complications- Fluid or electrolyte imbalance such as low blood potassium (if excessive vomiting or diarrhea)
- Injuries from falls (with postural dizziness)
- Kidney failure(from urine backup)
- Malnutrition
- Psychological/social effects of impotence
Call for an appointment with your health care provider if you have symptoms of autonomic neuropathy. Early symptoms might include:
- Becoming faint or lightheaded when standing
- Changes in bowel, bladder, or sexual function
- Unexplained nausea and vomiting when eating
Early diagnosis and treatment increases the likelihood of controlling symptoms.
PreventionPreventing or controlling disorders associated with autonomic neuropathy may reduce the risk. For example, diabetics should closely control blood sugar levels. Alcoholics should stop drinking.
ReferencesAmerican Diabetes Association (ADA). Standards of medical care in diabetes--2008. Diabetes Care. 2008;31:S12-S54.
Vardi M, Nina A. Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus. Cochrane Database Syst Rev. 2007;24(1):CD002187.
Benarroch E, Freeman R, Kaufman H. Autonomic nervous system. In: Goetz CG, eds. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 21.
What else can I help you with?
Can a person die from idiopathic peripheral autonomic neuropathy?
There is no usual evidence that indicates that idiopathic peripheral autonomic neuropathy is fatal.
What is a pandysautonomia?
A pandysautonomia is a form of autonomic neuropathy.
What does diffuse peripheral neuropathy affect?
Diffuse peripheral neuropathy primarily affects the limbs, damaging the nerves of the feet and hands. Autonomic neuropathy is the other form of diffuse neuropathy and it affects the heart and other internal organs
What are four types of diabetic neuropathy?
1. Peripheral 2. Focal 3. Autonomic 4. Proximal
Can Polyneuropathy with Autonomic Neuropathy symptoms lead to Multiple System Atrophy?
Yes it can do that, CIDP long term can turn into ALS, and MSA can start off with neuropathy symptoms and later turn into full blown MSA.
What are the different types of neuropathy?
The four major forms of nerve damage are polyneuropathy, autonomic neuropathy, mononeuropathy, and mononeuritis multiplex. The most common form is peripheral polyneuropathy, which mainly affects the feet and legs. Often the form of neuropathy is further broken down as to cause (see below), or other type, such as small fiber peripheral neuropathy, which is idiopathic. There are other less common forms of neuropathy, for example Enteric Neuropathy.11. http://en.wikipedia.org/wiki/Neuropathy
Can diabetes cause your feet to burn on the bottom?
Neuropathy is a common problem in patients with diabetes. Unfortunately, it is only partially prevented by good glucose control. Neuropathy can cause numbness, tingling, or burning in the affected areas, which is not reversible. It is usually progressive. Neuropathy not only occurs in the somatic nerves (sensory nerves), but also in the autonomic nerves, where it causes gastroparesis.
What can diabetic neuropathy lead to?
can lead to muscular weakness, loss of feeling or sensation, and loss of autonomic functions such as digestion, erection, bladder control, and sweating among others
What is the medical term meaning the condition of not feeling?
anesthiosisThe medical term for loss of sensation is anesthesia.anethesiaHSAN - which stands for Hereditary Sensory Autonomic Neuropathy. - This is the medical term for not feeling pain.
What is autonomic neuropathy?
It's also known as "visceral nervous system" which unconsciously and involuntary controls your visceral functions (heart and respiration rates, digestion, salivation, and many others).
Can teens get the disorder HSAN?
Yes, teens can be diagnosed with hereditary sensory and autonomic neuropathy (HSAN), a group of genetic disorders that affect sensory and autonomic nerves. Symptoms often appear in childhood or adolescence, leading to issues like reduced sensation, especially in the limbs, and autonomic dysfunction. Early diagnosis and management are crucial for improving quality of life and preventing complications. If there are concerns about HSAN, it's important for teens to consult a healthcare professional for evaluation.
What conditions require checking with a doctor before using dicyclomine?
Liver disease Kidney disease High blood pressure Heart problems Enlarged prostate gland Hiatal hernia Autonomic neuropathy (a nerve disorder) Hyperthyroidism
