Dysautonomia: Causes, Symptoms and Treatments

Overview

• Dysautonomia: Term for disorders of the autonomic nervous system (ANS), which regulates automatic bodily functions.
• Role of ANS: Maintains homeostasis managing heart rate, digestion, respiration, etc.
• Impact: Affects 70 million people worldwide.

Common Symptoms

• Difficulty standing still
• Fatigue
• Lightheadedness
• Nausea and GI symptoms
• Brain fog
• Palpitations
• Shortness of breath

Organ Systems Affected

• Neurological
• Pulmonary
• Cardiovascular
• Urinary
• Gastrointestinal
• Secretomotor
• Pupillomotor

Orthostatic Intolerance

• Difficulty maintaining upright posture due to abnormal blood pressure and heart rate.
• Symptoms: Lightheadedness, dizziness, brain fog, and fainting.
• "Coat hanger sign": Neck and shoulder pain when standing.

Types of Dysautonomia

• Common Types: Postural Orthostatic Tachycardia Syndrome (POTS), neurocardiogenic syncope.
• Variability: Can occur at any age and be mild to disabling.

Age and Onset

• Pediatric Onset: Rare, includes familial dysautonomia and Hirschsprung’s disease.
• Teen/Adult Onset: Often linked to another condition like diabetes or injury.
• Ages 50+: Often reflects neurodegenerative diseases.

Classification

• Primary: Autonomic dysfunction as main disease.
• Secondary: Due to another condition (e.g., diabetes).
• Idiopathic: Unknown primary cause.

Diagnosis

• Assessment: Comprehensive medical history and physical exam.
• Tests: Orthostatic vitals, Tilt Table Test, QSART, Valsalva Maneuver.

Treatment

• No cure, but symptoms can be managed.
• Increased water and salt intake.
• Exercise and non-pharmacological treatments.

Non-Pharmacological Treatments

• Education, exercise, fluid management, salt intake.
• Dietary considerations, compression garments.

Pharmacological Treatments

• Medications like Fludrocortisone, Midodrine, beta-blockers.

Alternative Treatments

• Acupuncture, massage, yoga, dietary adjustments.

Prognosis

• Varies widely; management focuses on reducing symptoms and improving quality of life.
• Importance of patient advocacy and partnership with healthcare providers.

Practical Living Tips

• Avoid dehydration, standing/sitting for long periods.
• Stress management and maintaining good sleep hygiene.

Additional Resources

• The Dysautonomia Project offers educational resources and support for patients and providers.