Dysautonomia is also called autonomic dysfunction or autonomic neuropathy. This term is used to define medical conditions that cause the malfunction of the autonomic nervous system (ANS). The ANS is the part of the nervous system that controls the involuntary functions of the body, such as heartbeat, blood pressure, breathing, digestion, kidney function, hormonal function, temperature control, sexual function and many other functions. People with an autonomic disorder have heart and blood pressure issues, as well as present with symptoms, such as breathing trouble, loss of bladder control and many other problems.
Primary and secondary dysautonomia
Dysautonomia can occur as a stand alone disorder without the presence of other diseases and is known as primary dysautonomia. It can also occur as an accompanying condition to other diseases and is known as secondary dysautonomia.
Some conditions caused by primary dysautonomia include
NCS also called situational syncope or vasovagal syncope is the most common form of dysautonomia. It is characterized by fainting spells that occur once or twice in a lifetime or multiple times every day.
Multiple system atrophy (MSA)
MSA is a rare fatal form of dysautonomia that usually occurs in people over the age of 40 years old. MSA causes heart rate issues, low blood pressure, erectile dysfunction and loss of bladder control. Patients usually become bedridden within two years of diagnosis and die within 5 to 10 years.
Pure autonomic failure
This is a rare degenerative disorder that causes posture-dependent hypotension, sexual dysfunction, a decreased ability to sweat, elevated blood pressure when lying down and changes in gastrointestinal and urinary habits. The condition affects men more often than women and is often found in middle-aged to older adults.
Afferent baroreflex failure
This is an autonomic disorder that causes fluctuations in blood pressure. The pressure keeps alternating between high and low due to a failure of the blood pressure-sensing nerves that relay information to the brain. It can be the result of a hereditary disorder or the result of a stroke, post-cancer surgery or radiation therapy.
Familial dysautonomia is a rare inherited condition that affects the development of the autonomic and sensory nervous systems. They may have reduced pain sensitivity, difficulty in regulating body temperature, absence of tears, excessive sweating, overproduction of saliva and mucus and blotchy reddening of the skin when excited or eating. During times of stress, people with familial dysautonomia may experience autonomic crises with extremely high blood pressure and heart rate accompanied by vomiting or retching.
Diseases in which secondary dysautonomia can occur include
- Parkinson’s disease
- Muscular sclerosis
- Rheumatoid arthritis
- Crohn’s disease, ulcerative colitis
- Celiac disease
- Charcot-Marie-Tooth disease
- Chiari malformation
- Vitamin B and E deficiencies
- Human immunodeficiency virus (HIV)
- Lyme disease
- Guillain-Barre syndrome
- Ehlers-Danlos syndrome
- Lambert-Eaton syndrome
- Sjogren syndrome
Triggers of dysautonomia
What are the symptoms of dysautonomia?
The symptoms and the severity of dysautonomia vary with patients and include
- Balance problems
- Inability to stay upright
- Dizziness, vertigo and lightheadedness
- Fainting spells
- Brain “fog/”forgetfulness/lack of focus
- Fast, slow or irregular heartbeat
- Heart palpitations
- Chest pain/discomfort
- Hypotension (low blood pressure)
- Problems with the gastrointestinal system
- Nausea and vomiting
- Visual disturbances (blurred vision)
- Breathing difficulties/shortness of breath
- Difficulty swallowing
- Mood swings
- Anxiety and depression
- Fatigue and inertia
- Intolerance to exercise
- Migraines or frequent headaches
- Sleeping problems
- Frequent urination or incontinence
- Sweat less than normal or not at all
- Temperature regulation problems
- Concentration and memory problems
- Poor appetite
- Noise/light sensitivity
- Erectile dysfunction
- Low blood sugar
- Exercise intolerance (heart rate does not adjust to changes in activity level)
- Frequent disturbing aches and pains
- Numbness and tingling
What is the treatment for dysautonomia?
There is no cure for this condition, but different therapies can be used to manage symptoms of dysautonomia.
The common treatments include
- Taking medications, such as fludrocortisone and midodrine, to increase blood pressure.
- Sleeping with the head raised about six to 10 inches higher than the body.
- Drinking more water every day to keep blood volume up, which helps relieve symptoms.
- Adding three to five grams of extra salt to the daily diet. Salt helps the body maintain normal fluid volume in blood vessels, thus maintaining normal blood pressure.
Secondary dysautonomia can be managed by correcting the underlying cause.