Autonomic neuropathy

Blausen 0838 Sympathetic Innervation

Autonomic neuropathy is a group of symptoms that occur when there is damage to the nerves that manage every day bodily functions such as blood pressure, heart rate, bowel and bladder emptying, and digestion. It is a form of peripheral neuropathy, which affects the nerves outside the brain and spinal cord. Autonomic neuropathy can be a complication of many diseases and conditions and can involve the disruption of the autonomic nervous system's normal workings.

Causes

Autonomic neuropathy can result from a variety of diseases and conditions. Some of the most common causes include:

• Diabetes mellitus, where it is known as diabetic neuropathy.
• Autoimmune diseases such as Sjögren's syndrome, celiac disease, and rheumatoid arthritis.
• Neurodegenerative diseases like Parkinson's disease and multiple system atrophy.
• Infections that can directly affect nerve tissues, such as HIV/AIDS and Lyme disease.
• Certain medications that can damage the nerves.
• Genetic conditions, such as familial dysautonomia.

Symptoms

Symptoms of autonomic neuropathy vary widely, depending on which organs are affected. They can include:

• Abnormal heart rate or blood pressure
• Excessive sweating or lack of sweating
• Gastrointestinal symptoms, such as constipation, uncontrolled diarrhea, or gastroparesis (delayed emptying of the stomach)
• Urinary problems, including difficulty starting urination, incontinence, and incomplete emptying of the bladder
• Sexual dysfunction, such as erectile dysfunction in men and problems with arousal and orgasm in women
• Difficulty regulating body temperature
• Vision problems, such as difficulty adjusting from light to dark

Diagnosis

Diagnosis of autonomic neuropathy involves a thorough medical history and physical examination, along with various tests to assess the functioning of the autonomic nervous system. These tests might include:

• Heart rate variability tests to assess the heart's response to deep breathing and changes in posture
• Blood pressure tests, including the response to standing (orthostatic hypotension)
• Gastrointestinal tests, if digestive symptoms are present
• Urinary tests, for bladder problems
• Sweat tests, to evaluate the sweat glands' function

Treatment

Treatment for autonomic neuropathy focuses on managing symptoms and underlying conditions. There is no cure for autonomic neuropathy, but treatments can significantly improve quality of life. Treatment strategies may include:

• Medications to manage symptoms such as abnormal heart rate, blood pressure, and digestive issues
• Lifestyle changes, including diet and exercise modifications
• Managing blood sugar levels for patients with diabetes
• Physical therapy to help with mobility and prevent complications
• Devices to assist with functions such as blood pressure regulation and urinary incontinence

Prognosis

The prognosis for autonomic neuropathy varies depending on the underlying cause, the severity of symptoms, and the effectiveness of treatment. Early diagnosis and treatment can improve symptoms and reduce the risk of complications.

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