Autonomic nervous system (ANS) dysfunction, which results in a condition known as dysautonomia, includes several disorders that interfere with normal autonomic nervous system responses. The autonomic nervous system is responsible for the involuntary actions that regulate our heart, gastrointestinal, urinary, muscles, and bowel functions as well as our metabolic and endocrine systems. Endocrine responses include reactions to stress or the flight or fight response. Dysautonomia is also referred to as autonomic failure and autonomic neuropathy.
Autonomic Nervous System
The autonomic nervous system is comprised of sensory, enteric, and motor systems. The motor systems include the sympathetic and parasympathetic nervous systems. The autonomic nervous system transmits sensory impulses that it receives from blood vessels, the heart and other organs in the chest, as well as the abdomen and pelvis. It transmits these impulses through nerves to other parts of the brain, primarily the medulla, pons and hypothalamus.
These impulses rarely reach our consciousness but they elicit automatic responses through the efferent autonomic nerves that cause appropriate reactions in the heart, vascular system and other organs. These impulses can result from stress, temperature changes, posture, food intake and other conditions to which the body is exposed.
Dysautonomia Disorders
Disorders of dysautonomia can result from both impaired and excessive functioning of the autonomic nervous system. Disorders in this family include Guillain-Barre syndrome, which is associated with vaccines, chronic inflammatory demyelinating polyneuropathy (CIDP), mitral vein prolapse dysautonomia, pure autonomic failure, postural orthostatic tachycardia syndrome (POTS), panic disorder, irritable bowel syndrome (IBS), neurocardiogenic syncope, multiple system atrophy (Shy-Drager Syndrome), chronic fatigue syndrome (CFS), fibromyalgia, and PANDA syndrome.
Who is Affected?
Disorders of autonomia may be familial or inherited or they may occur as autoimmune conditions. Dysautonomia may occur as a primary disease or it can occur as a secondary disease in people with other autoimmune disorders, alcoholism or Parkinson’s disease. Autoimmune dysautonomia is more likely to occur in people with other autoimmune diseases, especially autoimmune thyroid disorders, diabetes, and Sjogren’s syndrome. It can be triggered by infectious agents, for instance the development of PANDA syndrome in children recovering from streptococcal infection, and following vaccines especially in Guillain-Barre syndrome.
Autoantibodies
Autoantibodies seen in autoimmune dysautonomia include antibodies to the ganglionic acetylcholine receptor and anti-basal ganglia antibodies.
Symptoms
Symptoms vary depending on the specific disorder but overall common symptoms include dizziness, fatigue, motor function disturbances, blurred vision, depression, vague but disturbing aches and pains, headache, exercise intolerance, severe anxiety attacks, numbness or tingling, impotence, dizziness with standing or exertion, gastrointestinal disturbances, tachycardia, hypotension, hypertension and other symptoms. Symptoms may be self-limited and resolve over time or they may be chronic and progressive. Usually, a cluster of symptoms develops and the specific symptoms can change over time.
Treatment
Treatment depends on the specific disorder present. Treatment is usually aimed at alleviating symptoms such as pain medications or at suppressing the immune system, such as the use of intravenous immunoglobulin (IVIG) therapy in Guillain-Barre syndrome.
Resources
Dysautonomia, National Institute of Neurological Disorders and Stroke, National Institutes of Health,
National Dysautonomia Research Foundation
