Autonomic dysfunction is a cluster of diseases caused by the failure of the autonomic nervous system (ANS) to control as basic body functions as rhythm of the heart, blood pressure, digestion, temperature, and hundreds more. The dysautonomia symptoms are likely to be nonspecific and most likely disabling and involve more than one system at the same time.

Autonomic dysfunction is caused by a variety of diseases like diabetes, neurological disease, infection, or drug. In the majority, irreversible conditions, but with successful therapy and diagnosis, symptoms of autonomic dysfunction will be reversed and quality of life considerably enhanced. Cause, symptom, diagnosis, and autonomic dysfunction treatment are discussed quite well in this blog.

What is Autonomic Dysfunction?

Autonomic nervous system (ANS) regulates involuntary body movement such as heartbeat, digestion, breathing rate, muscle contraction and eye relaxation, and temperature. ANS is regulated by two systems: sympathetic nervous system, which regulates "fight or flight," and parasympathetic nervous system, which regulates "rest and digest.".
If ANS is destroyed, disease of the autonomic nervous system or autonomic dysfunction ensues.

The disease causes derangement of the body's self-regulating mechanism which also, in general, follows by generalized and non-specific manifestations. Autonomic dysfunction can be primary, of unknown etiology (e.g., pure autonomic failure), or secondary, secondary to disease such as autonomic dysfunction in diabetes, Parkinson's disease, or autoimmune disease.

Common Causes of Autonomic Dysfunction

It is advantageous to know what causes autonomic dysfunction so that one can provide tailored care. There are many reasons, medical, genetic, and environmental, and although an anamnestic etiology of ANS dysfunction:

Chronic Diseases

  • Diabetes Mellitus: Extremely common cause of autonomic neuropathy, which injures nerves that control the ANS.
  • Parkinson's Disease: Common cause of secondary dysautonomia secondary to decades-of-damage to nerves.
  • Multiple Sclerosis and Lupus: Autoimmune illnesses that could result in inflammation and malfunctioning of the ANS.

Infections

Infectious illnesses such as COVID-19, Epstein-Barr infection, or Lyme disease have been known to be involved in acute or chronic dysautonomia.

Genetic Disorders

Familial dysautonomia or Ehlers-Danlos syndrome could be the reason for dysautonomias.

Medications

Some medications, particularly with antihypertensive or nervous effect, could most likely interrupt autonomic control.

Neurological Injuries

Head, spinal cord, or peripheral nerve damage may result in malfunctioning or autonomic nervous system failure.


Autonomic Dysfunction Symptoms and Signs

Since ANS controls so many functions of the body, dysautonomia signs and symptoms may be very nonspecific. They don't know that they are ill but cannot find a familiar picture of something being wrong.

  • Heart Rate Abnormalities: Abnormal heart rate (tachycardia) or extremely slow heart rate (bradycardia), especially on standing.
  • Blood Pressure Changes: Spontaneous decreases (orthostatic hypotension) or spontaneous rise without apparent reason.
  • Gastrointestinal Symptoms: Bloating, constipation, nausea, or gastroparesis due to abnormally acting gastrointestinal motility.
  • Excessive or Restricted Sweating: Inability of sweating impairs temperature regulation.
  • Dizziness and Light-Headedness: Especially on postural change from sitting to standing.
  • Chronic Fatigue: Non-specific but highly prevalent symptom that adversely affects daily function.
  • Visual Disturbances: Double vision, especially on change of position.
  • Bladder and Bowel Dysfunction: Fecal and urinary incontinence or retention and bowel dysfunction.
  • Emotional Impact: Co-existent autonomic dysfunction and anxiety as cause or effect of chronic symptoms.
It should be remembered that even it is possible that none of the patients might share the same set of symptoms and hence even diagnosis gets complicated.

Diagnosis of Autonomic Dysfunction

Diagnosis of autonomic dysfunction is a doctor's appointment, typically with a cardiologist or neurologist. There are some tests which can be run to diagnose and find the cause.

Common Types of Diagnosis:

  • Autonomic Testing: Tilt table test, Valsalva maneuver, and sweat testing. These assess your response to change of position, respiration, and change of temperature.
  • Heart Rate and Blood Pressure Monitoring: Rest and exercise, using equipment like Holter monitors.
  • Blood Tests: To screen for diabetes, autoimmune disease, infection, or vitamin deficiency.
  • Nerve Conduction Studies: To diagnose autonomic neuropathy or peripheral nerve injury.
  • Imaging: To rule out the existence of brain or spinal cord lesion, CT scans or MRI is performed.
The larger the initial diagnosis, the better the treatment and better long-term result.

Few Modes of Treatment

Autonomic dysfunction is non-treatable but the different managing autonomic dysfunction modalities increase the quality of life and the intensity of the symptoms. The treatment thus devised tries to control the symptoms, achieve a balance among the etiologies, and offer an equilibrium function to the body.

Changes in Life

  • Supplementation of Fluid and Salt: Can be applied in an effort to regulate the blood pressure.
  • Compression Stockings: Prevents pooling of blood in the legs and thus the dizziness and syncope.
  • Head Elevation on Rest: Enhanced nocturnal control of blood pressure.
  • Exercise Programs: Low-level aerobics and resistance are capable of improving autonomic stability.
  • Dietary Adjustment: Consume several small meals in a bid to prevent postprandial hypotension.

Pharmacology

  • Fludrocortisone: Corticosteroid which enhances salt retention and rise in blood volume.
  • Midodrine: To increase low blood pressure.
  • Beta-blockers: Controls heart rate in POTS or other similar autonomic nervous system disorders.
  • Prokinetics: Enhances gut motility if chief complaint is cramp stomach.
  • Antidepressant or Anti-anxiety drug: If acute co-morbid symptom of anxiety.

Treatment of Underlying Disorder

  • Diabetic Control: Controlled blood sugar could prevent or exclude diabetic autonomic dysfunction.
  • Autoimmune Disease Treatment: Suppresses inflammation and subsequent symptoms by immunotherapy or biologic therapy.
  • Termination of Cause Medications: Re-set offending scripts causing autonomic imbalance.

Support and Therapies

  • Physical Therapy: Increases muscle tone and perfusion by particularly useful in orthostatic intolerance.
  • Support Groups and Counselling: Open symptoms along with those having chronic disease are in colossal emotional need of support.

Conclusion

Autonomic dysfunction includes all the most critical functions, and thus is an annoying but subtle illness to diagnose and treat. It can include anything from autonomic dysfunction and heart rate and blood pressure to nausea and drowsiness to disable all the functions of life necessary. While it is probably an entity related to chronic illness like diabetes or neurologic illness, early diagnosis and specific treatment could have a dramatically positive effect.

Treatment of autonomic dysfunction is primarily lifestyle change, drug therapy, and treatment of the underlying condition. Early diagnosis and treatment are the primary determinants of quality of life and return of function.
Referral for comprehensive assessment for autonomic nervous system disorder if you or your relative experience more than one symptom without obvious reason.

Please book an appointment with the best Neurologist in Lahore, Karachi, Islamabad, and all major cities of Pakistan through InstaCare, or call our helpline at 03171777509 to find a verified doctor for your disease.