Autonomic neuropathy is a group of symptoms that occur when there is damage to the nerves that manage every day body functions such as blood pressure, heart rate, bowel and bladder emptying, and digestion.
Neuropathy - autonomic
Causes, incidence, and risk factors
Autonomic 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 pressure and body temperature.
Autonomic neuropathy is associated with the following:
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.
Treatment 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 of light-headedness or dizziness when standing. These include:
Extra salt in the diet or taking salt tablets to increase fluid volume in blood vessels
Fludrocortisone or similar medications to help your body retain salt and fluid
Sleeping with the head raised
Wearing 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. See: Bowel retraining and Neurogenic bladder for information about treatment of these conditions.
Phosphodiesterase type 5 (PDE-5) drugs, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) may be used for treating impotence. Discuss the use of these medications with your doctor.
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.
Fluid or electrolyte imbalance such as low blood potassium (if excessive vomiting or diarrhea)
In the clinic. Type 2 diabetes. Ann Intern Med. 2007 Jan 2;146(1):ITC1-15.
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.
Daniel Kantor, MD, Medical Director of Neurologique, Ponte Vedra, FL and President of the Florida Society of Neurology (FSN). Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.