Dysautonomia is a term that refers to disorders of the autonomic nervous system (ANS). The autonomic nervous system manages involuntary bodily functions—the functions the body regulates without having to think about them, such as breathing, blood pressure, heart rate, and bladder control. Dysautonomia involves failure of various ANS functions and can be sudden and reversible—as in Guillain-Barré syndrome—or chronic and progressive.
Number of people affected by dysautonomia worldwide
Distinct forms of dysautonomia
People in the U.S. with postural orthostatic tachycardia syndrome (POTS), a common form of dysautonomia
Dysautonomia can have different causes. It can be a primary disorder, as in the case of central autonomic disorders like multiple system atrophy (MSA). It can also occur as a secondary disorder associated with another condition, such as neurodegenerative diseases like Parkinson’s disease, or conditions like diabetes, alcoholism, celiac disease, rheumatoid arthritis, and lupus.
People of any age, gender, or race can have dysautonomia. In some cases, dysautonomia is hereditary, which is known as familial dysautonomia (FD).
Dysautonomia generally involves a failure of the autonomic nervous system, but it can also involve overactivity of the ANS. Dysautonomia can be local (one area of the body) or generalized (throughout the body).
People with dysautonomia have trouble regulating the functions of their autonomic nervous system. When the ANS is not working properly, it can cause a variety of symptoms that may range from mild to severe.
Symptoms may include:
For many people, it can take years to receive an accurate diagnosis due to a lack of awareness of dysautonomia and its various forms. To diagnose dysautonomia, a doctor may conduct blood tests, a tilt table test, and other autonomic testing to measure breathing, blood pressure and blood flow, heart rate, and skin temperature. These tests help determine the specific form of dysautonomia and establish the appropriate treatment.
There is no specific cure for dysautonomia. The outlook often depends on the cause or category of the disorder. In some cases, symptoms go away on their own or stay the same without worsening. In others, the disorder is chronic and progressive. If dysautonomia is associated with a secondary disease, then effectively treating that disease can improve dysautonomia.
In some cases, symptoms may be relieved by lying down, which helps restore normal blood flow to the brain and upper body. Typically, doctors provide medications or other therapies to manage specific symptoms, such as blood pressure drops upon standing or bladder control issues. These treatments may include water bolus (rapid infusion of water given via IV) or drugs like fludrocortisone and midodrine. Lifestyle changes like elevating the head of one’s bed, a high-salt diet, and adequate hydration can also improve symptoms.
Ongoing research aims to better understand the causes of dysautonomia and find new, more effective ways to diagnose, treat, and prevent these disorders.
National Organization for Rare Disorders: Familial Dysautonomia
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