What is autonomic neuropathy?

Autonomic neuropathy is also called autonomic dysfunction or dysautonomia. These terms describe many conditions that cause the autonomic nervous system (ANS) not to work. The ANS controls the body functions that we do not consciously think about: breathing, blood pressure regulation, digestion, temperature regulation, and more. Autonomic neuropathy can be a complication of many diseases and conditions and can be a side effect from some medications.

What causes autonomic neuropathy?

There are many underlying diseases and conditions that can lead to autonomic neuropathy. Medication side effects can also be a problem.

Primary causes of autonomic neuropathy include:

  • Familial dysautonomia (Riley-Day syndrome)
  • Idiopathic orthostatic hypotension (progressive autonomic failure)
  • Multiple system atrophy with autonomic failure (Shy-Drager syndrome)
  • Parkinson’s syndrome with autonomic failure

Secondary causes of autonomic neuropathy include:

  • Amyloidosis (abnormal protein build-up)
  • Autoimmune neuropathies (i.e., Guillain-Barre syndrome, myasthenia gravis, rheumatoid arthritis, Sjogren’s syndrome, and systemic lupus erythematosus)
  • Carcinomatous autonomic neuropathy (often related to small-cell lung cancer
  • Deconditioning (a decrease in function due to inactivity or illness)
  • Diabetes and pre-diabetes
  • Human immunodeficiency virus (HIV)
  • Lyme disease (a disease transmitted by ticks and causing flu-like symptoms)
  • Nutritional deficiencies (i.e., vitamins B1, B3, B6, and B12)
  • Paraneoplastic syndromes (disorders caused by an immune response to cancer)
  • Physical trauma, surgery, pregnancy, or viral illness
  • Porphyria (an enzyme disorder that mainly causes skin and/or nerve problems)
  • Toxicity (i.e., alcoholism, chemotherapy drugs, and heavy metal poisoning)
  • Treatment with medicines, including chemotherapy and anticholinergic drugs

What are the symptoms of autonomic neuropathy?

Common symptoms include:

  • Postural hypotension: lightheadedness, dizziness, fainting, dimness of vision, unsteady gait, weakness
  • Urinary dysfunction: frequency, excessive urinating at night, urgency, stress incontinence, retention, hesitancy
  • Sexual dysfunction: erectile dysfunction, vaginal dryness, decreased libido
  • Gastrointestinal dysfunction: intermittent diarrhea, constipation, nausea, vomiting, full-ness after eating little, loss of appetite, slowing of gastric content, bloating, heartburn
  • Impaired sweating: excessive or decreased sweating
  • Exercise intolerance
  • Paresthesias: numbness or tingling in feet, legs, hands, arms or other body parts
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