Autonomic Neuropathies

Abstract

The autonomic nervous system (ANS) maintains homeostasis of all major organs relative to the external environment. The ANS is subdivided into the sympathetic, parasympathetic, and enteric nervous systems. Disorders of the ANS can lead to cardiovascular, sudomotor, gastrointestinal, or urogenital dysfunction. When addressing potential disorders of the ANS, a detailed history provides essential information on which autonomic domains are involved, and whether the ANS disorder is focal or widespread. Several bedside tests can be used to confirm a suspected diagnosis. Management of autonomic disorders includes nonpharmacological as well as pharmacological approaches. In this chapter, we present an overview of ANS neuroanatomy and discuss common autonomic syndromes, how to evaluate them at the bedside and, when needed, in an autonomic laboratory. We also discuss current recommendations, including lifestyle modifications, and a structured approach to physical and pharmacological options.