Dysautonomia
From Wikipedia, the free encyclopedia
| Dysautonomia Classification and external resources |
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| ICD-10 | G90. |
|---|---|
| ICD-9 | 337.9 |
| MeSH | D001342 |
Dysautonomia is any disease or malfunction of the autonomic nervous system. This includes postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, mitral valve prolapse dysautonomia, pure autonomic failure, autonomic instability and a number of lesser-known disorders. Other disorders, such as multiple system atrophy (Shy-Drager syndrome)[1] and chronic fatigue syndrome, [2] have dysautonomia as one of several system malfunctions.
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[edit] Presentation
In some cases, dysautonomia results in a reduction in the ability of the heart and circulatory system to compensate for changes in posture, causing dizziness or syncope (fainting) when one, e.g., stands suddenly. In other cases, the heart may race (tachycardia) for no apparent reason (known as Inappropriate sinus tachycardia),the patient may experience severe migraines regularly, or the kidneys may fail to properly retain water (diabetes insipidus). Can also cause chronic headaches and may be seen together with Chronic Fatigue Syndrome.
The effects of dysautonomia may be minor, only limiting the patient's activities slightly, or they may be totally disabling, leaving the patient bedridden.
[edit] History
In the nineteenth and earlier twentieth centuries, a diagnosis that was almost solely given to women was called "neurasthenia," or a "weak nervous system." These women would present symptoms of fatigue, weakness, dizziness and fainting, and the doctor's orders would simply be bed rest. Some of these women died, while many others recovered. No one understood where the problems came from.
With the advances in modern medicine, diagnostic criteria and treatment for various forms of dysautonomia have sharpened. Doctors and researchers are including males in their subject population for this disorder.
[edit] Causes
Causes of dysautonomias are not fully understood, but they are thought to include viral illness, genetic factors, exposure to chemicals, pregnancy, autoimmune disorders, and a trauma or injury[3] which damages the autonomic nervous system.
[edit] Treatment
There is no cure for dysautonomia. There are medications to assist in stabilization, but are often needed on a long-term basis. Secondary forms may improve with treatment of the underlying disease. In many cases treatment of primary dysautonomia is symptomatic and supportive. Measures to combat orthostatic intolerance include elevation of the head of the bed, frequent small meals, a high-salt diet, fluid intake, and compression hose. Drugs such as fludrocortisone, midodrine, ephedrine, and SSRIs can also be used to treat symptoms. Treating dysautonomia can be difficult. Treatment that helps one individual may actually worsen the symptoms of another. Often drugs and measures that are helpful are found through trial and error.
[edit] Prognosis
The outlook for patients with dysautonomia depends on the particular diagnostic category. Most forms of dysautonomia are not life threatening, even if life changing in the form of minor to major limitations in activities of daily living. Patients with chronic, progressive, generalized dysautonomia in the setting of central nervous system degeneration have a generally poor long-term prognosis. Death can occur in young children and the elderly. Younger patients can die from pneumonia, acute respiratory failure, or sudden cardiopulmonary arrest.
There is some evidence that dysautonomia may be a factor in SIDS (sudden infant death syndrome).
[edit] References
- ^ Köllensperger M, Stampfer-Kountchev M, Seppi K, et al (2007). "Progression of dysautonomia in multiple system atrophy: a prospective study of self-perceived impairment". Eur. J. Neurol. 14 (1): 66–72. doi:. PMID 17222116.
- ^ Newton JL, Okonkwo O, Sutcliffe K, Seth A, Shin J, Jones DE (2007). "Symptoms of autonomic dysfunction in chronic fatigue syndrome". QJM 100 (8): 519-26. doi:. PMID 17617647.
- ^ Baguley IJ, Heriseanu RE, Cameron ID, Nott MT, Slewa-Younan S (2007). "A Critical Review of the Pathophysiology of Dysautonomia Following Traumatic Brain Injury": 293. doi:. PMID 17968518.
- Dysautonomia Youth Network of America, Inc.
- American Dysautonomia Institute
- National Dysautonomia Research Foundation (NDRF)
- Dysautonomia Information Network
- A family of misunderstood disorders, by Richard N Fogoros
- Dysautonomia Support Network (aka POTS Support Network)
[edit] See also
[edit] External links
- Dysautonomia Information Network
- Dysautonomia Youth Network of America, Inc. (DYNA)
- American Dysautonomia Institute
- dysautonomia at NINDS
- Dysautonomia Support Network (aka POTS Support Network)
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