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Dysautonomia: What Is Autonomic Dysfunction?

Dysautonomia: What Is Autonomic Dysfunction?
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Dysautonomia


Dysautonomia refers to the autonomic nervous system malfunctioning. The autonomic nervous system is responsible for all of the functions in your body that happen automatically, without your control. This includes breathing, heartbeat, digestion, etc. In dysautonomia, or autonomic dysfunction, the autonomic nervous system sends the wrong signals – or no signals at all – to organ systems. This results in complications like an irregular heartbeat, respiratory problems or digestive issues.

What Causes Dysautonomia?

A long nerve that runs down the back and sides of the neck, called the vagus nerve, is responsible for many autonomic functions. Damage to this nerve can result in dysautonomia. Dysautonomia can also be hereditary, meaning it is passed down from family members. Types of dysautonomia can also occur completely at random during young adulthood, and then subsequently resolve completely randomly with age. In many cases, dysautonomia is brought on by underlying conditions including, but not limited to the following:

  • Epstein-Barr
  • Meningitis
  • Chiari Malformation
  • Ehlers Danlos Syndrome
  • Craniocervical Instability
  • Lyme Disease
  • Autoimmune Diseases
  • Diabetes

Types of Dysautonomia

POTS (Postural Orthostatic Tachycardia Syndrome)

POTS stands for Postural Orthostatic Tachycardia Syndrome. In POTS, the body doesn’t respond properly to being in an upright position. When the patient goes from laying down or sitting down to standing up, their blood pressure drops and their heart begins to race. If the heartrate increases by at least 30 beats per minutes, it is considered POTS. This condition also causes blood to pool in the extremities upon standing, rather than circulating through the body as it should.

Neurocardiogenic Syncope

Neurocardiogenic syncope, also known as vasovagal syncope, is considered the most common cause of fainting. Neurocardiogenic syncope occurs when the patient experiences a sudden and significant drop in blood pressure that leads to passing out. This sudden drop in blood pressure can be brought on by standing up too fast, straining to lift something, or getting overheated.

Gastroparesis

Gastroparesis refers to a slowing down or entire paralysis of the digestive system. Normally, the stomach moves ingested food into the small intestines for digestion. In gastroparesis, ingested food sits in the stomach, preventing the body from absorbing nutrients and properly digesting food.

Dysautonomia Symptoms

Because there are multiple types of dysautonomia that affect various body systems, the symptoms of dysautonomia are wide-ranging.

  • Tachycardia
  • Bradycardia
  • Heart Palpitations
  • Hypotension
  • Orthostatic Intolerance – Hypotension and Tachycardia Upon Standing
  • Nausea
  • Vomiting
  • Constipation
  • Bloating
  • Bladder Dysfunction
  • Dizziness
  • Brain Fog
  • Memory Problems
  • Blurry Vision
  • Heat/Cold Intolerance
  • Excessive Sweating
  • Headaches
  • Muscle and Joint Pain
  • Incontinence
  • Fatigue
  • Noise Sensitivity

Diagnosing Dysautonomia

To diagnose dysautonomia, you need to determine what type is suspected. For example, if POTS is suspected, testing may include a tilt table test. A tilt table test consists of the patient being strapped to a table, initially lying flat, and then transitioning them into an upright position. The patient’s blood pressure and heart rate is then noted to see the variation between supine and upright position.

Neurocardiogenic syncope can usually be diagnosed based on patient’s symptoms. If a patient reports frequent incidents of fainting, it may be due to neurocardiogenic syncope. An MRI of the brain should be done to rule out neurological conditions, as well as a full cardiac workup to check that heart function is healthy.

There are multiple diagnostic tests to diagnose gastroparesis. Gastric emptying scans can assess how long it takes the stomach to push through food that is consumed. Various blood tests may be done to evaluate how well nutrients are being absorbed by the patient. Imaging tests like x-rays and MRIs should also be done to rule out any structural problems in the digestive tract, such as blockages or tumors.

Treating Dysautonomia

Treating dysautonomia depends on the type of autonomic dysfunction the patient has. This determines the type of specialist the patient needs to see for treatment. For instance, POTS is typically treated by a cardiologist or an electrophysiologist. POTS patients may also want to work with a neurologist in addition to a cardiac doctor. Treatment will typically consist of medications to lower heart rate and increase blood pressure. Additional treatment would be certain lifestyle changes, such as wearing compression stockings and increasing salt and fluid intake to boost blood pressure.

A neurologist and cardiologist may be used to treat patients with neurocardiogenic syncope. The treatment of neurocardiogenic syncope would consist of lifestyle changes, such as avoiding things that trigger fainting. A patient may also take medication to increase blood pressure or wear compression stockings to prevent blood from pooling in the lower extremities.

A gastroenterologist and neurologist may be used to treat gastroparesis. Treatment options include lifestyle changes, such as eating smaller meals and foods that are easier to digest. Medications to aid digestion may also be taken. In severe cases, a feeding tube may be needed to provide the patient with nutrition.

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