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
1. Sympathetic
(L3- T1)
1. Parasympathetic
(S2-S4)
Cranial nerves 3,7,9,10

6. 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!

7. 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.

8. 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:

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

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

12. 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

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

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

16. Management & treatment
 Pharmalogical :
• Atropine can be used for both prevention and.
• Topical anesthemanagementsia can really
redue the reflex
• Vasopressors injections for hypotension.

17. Iv saline
Exercise
Physical
activity
Cooling
vests
wheelchair
canes
Non pharmacological factors :

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

19. Summary
 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.