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Signs of Dysregulation: Do You Know Which Diseases May Cause Autonomic Dysfunction?
Dyfunction of the autonomic nervous system (ANS), often referred to as dysautonomia, is a condition that affects multiple systems including the heart, bladder, intestines, sweat glands, pupils, and blood vessels. Dysautonomia has many causes and is not limited to neurological disorders. Many diseases today are associated with autonomic dysfunction, including Parkinson's disease, Alzheimer's disease with Lewy bodies, Ehlers–Danlos syndromes, and autoimmune autonomic ganglionopathy. ), HIV/AIDS, etc.
Diagnosis of dysautonomia usually requires functional testing to focus on the affected organ system.
Signs and symptoms
There are many types of symptoms of autonomic dysregulation, which appear differently in different people. Among them, postural orthostatic tachycardia syndrome (POTS) is one of the most common conditions.
When patients experience autonomic nervous system disorders, they may experience the following symptoms:
- Heart beating rapidly
- Dizziness or fainting
- Digestive problems, such as delayed gastric emptying
- Abnormal sweating
- Difficulty with sexual function
Cause
Autonomic nervous system disorders may result from genetic or degenerative neurological diseases, or they may be acquired diseases that cause damage to the autonomic nervous system.
Common causes also include fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, etc.
Anxiety may also present symptoms similar to those of autonomic dysfunction in some cases, so it is important to understand the background and physiological causes of different symptoms. For those patients for whom no clear cause can be found, an underlying anxiety disorder may need to be considered.
Mechanism
The autonomic nervous system is divided into two main parts: the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system regulates the body's active responses, such as increasing heart rate and blood pressure, while the parasympathetic nervous system slows the heart rate and aids digestion.
Diagnosis
The diagnosis of autonomic nervous system disorders relies on multiple tests such as cardiovascular response, adrenal response, and sweating response. Blood pressure and heart rate are usually measured after lying down and standing for several minutes, and a series of tests including a tilt table test and a sweat response test are performed.
Investigation of potential causes includes assessment of nerve conductance, magnetic resonance imaging, etc.
Vegetative angiodystrophy
In some literature, the subtype of dysautonomia, which specifically affects the vasculature, is called vegetative angiodystrophy. This symptom has been documented many times throughout history, particularly during some wars and has been called "irritable heart syndrome."
Management and Treatment
Treating dysautonomia is often difficult because the symptoms are diverse and often require different medications for each symptom. For autoimmune neuropathies, immunomodulatory therapy is often indicated.
For example, for conditions caused by diabetes, controlling blood sugar is critical, and for digestive symptoms, medications such as proton pump inhibitors may be used.
Prognosis
The prognosis of dysautonomia depends on many factors. Patients with degenerative conditions of the central nervous system, such as Parkinson's disease or multiple system atrophy, generally have a poorer long-term prognosis, and symptoms of autonomic dysfunction such as orthostatic hypotension, gastroparesis, etc., are more likely to be associated with mortality.
With these changing symptoms, can you think of potential diseases that have not yet been recognized?
