Dysautonomia

Dysautonomic symptoms include syncope, postural hypotension, paroxysmal hypertension, persistent tachycardia without other cause, facial flushing, hypohidrosis or hyperhidrosis, vomiting, constipation, diarrhea, dysphagia, abdominal distention, disturbances of micturition or defecation, apneic episodes, and declining night vision. In syncope, prodromal malaise, nausea, headache, diaphoresis, pallor, visual disturbance, loss of postural tone, and a sense of weakness and impending loss of consciousness are followed by actual loss of consciousness. Although the patient is usually flaccid, some motor activity is not uncommon, and urinary (and rarely fecal) incontinence may also occur, thereby simulating a seizure. Recovery is rapid once the patient becomes recumbent, but headache, nausea, and fatigue are common postictally.

Dysautonomia is any disease or malfunction of the autonomic nervous system The autonomic nervous system manages most of our bodily systems, including the cardiovascular system, gastrointestinal, urinary and bowel functions, temperature regulation, reproduction and our metabolic and endocrine systems. People would find themselves suddenly unable to function, due to a host of inexplicable symptoms, often including fatigue, weakness, strange pains, dizziness and passing out. In a normal situation, the two divisions of the autonomic nervous system work together to control these functions in a continuous manner reacting normally to stimulus. The transmission is autosomal recessive with complete penetrance, and with the exception of one patient, all proven cases have been of Ashkenazi Jewish extraction. The prognosis may be one that calls for an abatement of symptoms, or an adjustment to living with a chronic impairment. Women with neurasthenia (for men were not given this diagnosis, by and large) were often confined to their beds, where they would either recover or, eventually, die. Dysautonomia also can occur as a primary condition or in association with degenerative neurological diseases such as Parkinson's disease. Other diseases with generalized, primary dysautonomia include multiple system atrophy and familial dysautonomia. . In other cases, the heart may race ( tachycardia ) for no apparent reason (known as Inappropriate sinus tachycardia ), or the kidneys may fail to properly retain water ( diabetes insipidus ). Most modern doctors hearing about this mysterious condition merely shake their heads in wonder. And whatever the symptoms and whatever the diagnosis, all these syndromes are real, honest-to-goodness physiologic (as opposed to psychologic) disorders probably variants of the same general disorder of the autonomic nervous system and while they can make anybody crazy, they are not caused by craziness.

Dysautonomia refers to a disorder of autonomic nervous system (ANS) function. Additionally, this system is responsible for our reaction to stress - the flight or fight response When our autonomic nervous system malfunctions, it is known as Dysautonomia. Most physicians view dysautonomia in terms of failure of the sympathetic or parasympathetic components of the ANS, but dysautonomia involving excessive ANS activities also can occur. Pathologic studies have shown marked reduction in nonmyelinated neuronal populations as well as reduction in small diameter myelinated axons. The autonomic nervous system suddenly decides to send out a burst of signals to speed up all body processes. When this occurs the symptoms may be extremely severe and frightening. Most modern doctors hearing about this mysterious condition merely shake their heads in wonder. Few seem to consider the possibility that "neurasthenia" is still with us. In other cases, the heart may race ( tachycardia ) for no apparent reason (known as Inappropriate sinus tachycardia), or the kidneys may fail to properly retain water ( diabetes insipidus ). Dysautonomia also can occur as a primary condition or in association with degenerative neurological diseases such as Parkinson's disease. The prognosis may be one that calls for an abatement of symptoms, or an adjustment to living with a chronic impairment The effects of dysautonomia may be minor, only limiting the patient's activities slightly, or they may be totally disabling, leaving the patient bedridden Prolonged bed rest following surgery, breaking a leg or something similar can cause dysautonomia. Understanding dysautonomia and its effect on the body and the appropriate ways to treat it will lead to proper methods of clearing up this condition.

Causes of Dysautonomia

Common causes of Dysautonomia :

• familial dysautonomia
• Autonomic neuropathy
• The disease is caused by mutation of the IKBKAP gene on chromosome 9.
• Children do not feel the normal sensations that generally warn of impending injury, such as drying of the eyes, pressure over pressure points, and chronic rubbing and chaffing.
• Causes of Dysautonomia's include viral illness, genetic factors, exposure to chemicals, pregnancy, trama or injury, and traumatic emotional experiences which damage the autonomic nervous system.
• Multiple system atrophy
• Familial dysautonomia

Symptoms of Dysautonomia

Some common Symptoms of Dysautonomia :

• recurring bouts of high blood pressure
• poor coordination - unsteady gait
• feeding difficulties -- poor sucking and poor ability to swallow, drooling
• lack of response to painful stimuli
• an unusually smooth tongue surface
• Irregular heartbeat or palpitations , especially while lying on the left side
• Chest pain - Sharp, dull, or pressing, lasting from a few seconds to several hours, usually not related to myocardial ischemia (that is, not a threatened heart attack )
• Anxiety Generalized anxiety disorder is the name for feeling much more anxiety than the amount, or degree, of anxiety that most people experience in their daily lives
• Low energy level, often misdiagnosed as chronic fatigue syndrome.

Treatment of Dysautonomia

The most disabling symptom of dysautonomia is usually postural hypotension and syncope. Abrupt postural change, prolonged recumbency, and other precipitants should be avoided. Medications associated with postural hypotension should be discontinued or reduced in dose. Treatment may include wearing waist-high elastic hosiery, salt supplementation, sleeping in a semierect position (which minimizes the natriuresis and diuresis that occur during recumbency), and fludrocortisone (0.1–0.2 mg daily). Vasoconstrictor agents may be helpful and include midodrine (2.5–10 mg three times daily) and ephedrine (15–30 mg three times daily). Other agents that have been used occasionally or experimentally are dihydroergotamine, yohimbine, and clonidine; refractory cases may respond to erythropoietin (epoetin alfa) or desmopressin. Patients must be monitored for recumbent hypertension. Postprandial hypotension is helped by caffeine. There is no satisfactory treatment for disturbances of sweating, but an air-conditioned environment is helpful in avoiding extreme swings in body temperature.

• Ensure adequate hydration not only during crisis episodes but also in apparently stable periods.
• Even the steady air current from an oxygen mask or nasal cannula blowing upward toward the eye may accentuate dryness and increase the risk of corneal epithelial breakdown.
• postural hypotension (low blood pressure when standing) can be managed with increased fluid and salt intake, caffeine, and waist-high elastic stockings
• liquid tears and bethanechol to prevent drying of eyes
• If a person has unusual heart rhythms, such as palpitations, she may need treatment with beta-blockers.
• During crisis episodes, the catecholamine surge causes a sustained contraction of Mueller muscle with eyelid retraction causing increased corneal exposure and drying.
• Special drug management of autonomic manifestations such as temperature regulation, blood .

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