Dysautonomia (Autonomic nervous system)

Autonomic nervous system illness and its clinical features

1. Dysautonomia NS Module Karrar Raafat Arif

2. Objectives: List main basic points about ANS( anatomy&function ). Define dysautonomia in simple terms. Identify the main causes of dysautonomia . Identify the signs and symptoms of patient with dysautonomia . Illustrate the most common disorders associate with dysautonomia . Illustate some clinical & diagnostic features.

3. AUTONOMIC NERVOUS SYSTEM is a division of the peripheral nervous system that supplies smooth muscle and glands. It is regulated by hypothalamus It acts unconsciously and controls bodily functions such as heart rate ,  digestion ,  respiratory rate ,  pupillary response ,  urination .( functionally ) Subdivided into sympathetic and parasympathetic nervous systems.

4. AUTONOMIC NERVOUS SYSTEM Anatomically : Lower brainstem Sympathetic (L3- T1) Parasympathetic (S2-S4) Cranial nerves 3,7,9,10

5. What is Dysautonomia ? Dys : referring to dysfunction. Autonomia : referring to the ANS. SO, It is a condition in which the autonomic nervous system (ANS) does not work properly. Break it down!

6. What are the causes of dysautonomia ? These are: Diabetes peripheral nerve damage Aging Parkinson disease Alcoholism . Multiple sclerosis(MS). HIV and AIDS. Spinal cord disorders . Ehlers- Danlos syndrome. Certain drugs.

7. Signs and symptoms Fatigue. Nausea with GI dysmotility like constipation. light-headedness. Dizziness. Tachycardia. Almost hypotention . Hyperthermia. Decreased sweating. Anxiety. Syncope and e.t.c . A patient with dysautonomia can present to clinic with some manifestations:

8. Most common types disorders associates with : dysautonomia Postural orthostatic tachycardia syndrome(POTs) which also called orthostatic hypotension. Parkinson disease

9. *POTs patients can barely change there posture without feeling dizzy.

10. Diagnosis There are some certain tests can be provided mainly by a neurologist: Valsava maneuver: is a medial examination as test of cardial function and ANS Mainly heart rate will inrease

11. Diagnosis Tilt table test : - in which heart rate increased. Elevate back of Patient from (0%-30%)

12. Other tests.. Urine test. Thermoregulatory sweat test. Patient history . Many other tests as well.

13. Management & treatment Pharmalogical : Atropine can be used for both prevention and. Topical anesthe management sia can really redue the reflex Vasopressors injections for hypotension.

14. Non pharmacological factors :

15. epidemiology Occurs in females > males a bout 5:1 in 1999 . It may follows flulike illness,limited autoimmune disease,surgery or injury,pregnancy,rapid growth spurt. Eating disorders ,hot wheather worsening

16. S ummary ANS regulates unconsciously bodily function necessary for our life. Vagus n.(CNX) controls these body functions almost all. Dysautonomia is a condition in which the autonomic nervous system (ANS) does not work properly. Symptoms of abnormal autonomic-nervous-system function occur commonly in Parkinson’s disease (PD). Orthostatic hypotension.