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Treating Autonomic Nervous System Disorders

Autonomic nervous system dysfunction is sometimes challenging to diagnose because it can cause many different types of symptoms that also occur with other conditions. As a result, you may need to see a multidisciplinary team of providers to fully evaluate your symptoms and help exclude any non-neurological problems. For example, a cardiologist may be sought out for low blood pressure issues or your may see a  urologist to understand your bladder problems. If, based on the nature of your symptoms, an autonomic nervous system problem is suspected, you may also benefit from an evaluation by a neurologist with training in this area of medicine.

Our neurologists at University of Utah Health offer a comprehensive evaluation for people with suspected autonomic nervous system dysfunction. We know what tests to order and how to interpret the results. Our specialists will provide your primary care physician with a detailed summary of your test results, as well as treatment recommendations. Some patients might continue to receive care from the neurologist in the short-term, but the goal is to help your primary care provider manage and coordinate your care long-term. Our neurologists are happy to work with your provider to ensure you get the care and support you need.

 

What Is Autonomic Dysfunction?

Symptoms of autonomic dysfunction can result from a variety of conditions, including a problem in the body’s nervous system.

Your nervous system is a complex network of nerves and cells (neurons) that send signals to and from different parts of the body. The nervous system has two main parts:

  • the central nervous system, which is made up of the brain, spinal cord, and nerves; and
  • the peripheral nervous system, which is made up of neurons, clusters of neurons, and nerves that connect to each other and the central nervous system.

How Does the Autonomic Nervous System Work?

The autonomic nervous system is composed of parts of both the central and peripheral nervous systems. It helps coordinate various bodily functions, such as blood flow, breathing, sweating, and digesting food. When something goes wrong with this system, it’s referred to as autonomic dysfunction.

Types of Autonomic Nervous System Disorders

Autonomic dysfunction may occur on its own (referred to as “idiopathic”), or may result from underlying conditions such as diabetes or Parkinson’s disease. Different types of autonomic dysfunction include:

  • Autonomic neuropathy— Causes include diabetes, toxic exposures, an infection, or autoimmune disorders.
  • Postural tachycardia syndrome (POTS) — POTS is not well understood, but is generally thought to be a problem with blood circulation that causes light-headedness, fainting, and an uncomfortable, rapid increase in heart rate. People with POTS may also have a wide array of other symptoms related to autonomic dysfunction, and in some cases, may also have an autonomic neuropathy.
  • Autonomic failure — Autonomic failure is caused by a wide array of underlying conditions such as Parkinson’s disease, stroke, multiple sclerosis, tumors, and other disorders of the central nervous system.

Autonomic Dysfunction Symptoms

People with autonomic dysfunction may experience a wide variety of mild to severe symptoms. A common symptom of autonomic failure and/or neuropathy is orthostatic hypotension, a form of low blood pressure that happens when standing up after sitting or lying down. This problem may also occur after eating, and can lead to dizziness, light-headedness, and falls.

Other symptoms include:

  • excessive or decreased sweating, salivating, or eye-tearing;
  • feeling hot or cold in some parts of or all over your body, due to issues that cause the blood vessels to narrow or widen;
  • gastrointestinal problems, such as constipation and slow digestion;
  • bladder issues, such as being unable to empty one’s bladder fully;
  • sexual problems, such as vaginal dryness and difficulty maintaining an erection; and
  • problems with your pupils that cause difficulty adapting to changes in light.

Autonomic Testing

These tests typically include autonomic reflex testing (ARS), which is noninvasive. During these tests, and a technician will measure your sweat output, skin temperature, heart rate, and blood pressure. It typically takes one to two hours. Our clinic staff will provide you with information to help you prepare.

Most people will undergo testing at the Autonomic Physiology Laboratory at University of Utah before seeing one of our neurologists. Our lab and neurology clinic are located at the Imaging and Neurosciences Center in Research Park, near U of U Health’s main campus.

Interpreting Your Test Results

The neurologist will review your test results and create a report that includes a diagnosis and detailed treatment plan. This report will be ready within about two weeks of your lab tests. The neurologist will send it to your referring physician, who may want you to see the neurologist for a follow-up appointment, or may ask you to make an appointment to see him or her.

Autonomic Dysfunction Treatment

Although there isn’t a cure for most types of autonomic dysfunction, treatment can help people manage their symptoms and experience a better quality of life. Your treatment plan may include:

  • taking medication to help stabilize blood pressure;
  • taking medication to control other symptoms, such as intolerance to hot temperatures, digestion issues, and bladder function;
  • consuming fluids that are fortified with electrolytes;
  • getting regular exercise; and
  • wearing garments to improve vasomotor issues—these can include compression stockings, compression leggings, and cooling vests, for example.

If an underlying issue, such as diabetes, hormone problems, or an infection, is causing your autonomic dysfunction or making it worse, the neurologist may provide treatment for the underlying problem or refer you to a specialist for an evaluation and care.

Request an Evaluation with Our Neurologists

You will need a referral from your primary care provider or other specialist to start the evaluation process. Your provider can make a referral by contacting our clinic via:

Phone: 801-585-7575 
Fax: 801-585-2746

Next Steps

After we receive the referral, a member of our neurology clinic staff will contact you to schedule your first appointment and send you a medical history questionnaire. We ask that you complete this and return it to the clinic by fax, email, or mail, if possible. Otherwise, be sure to bring it to your first appointment.