Dysautonomia is any disease or malfunction of the autonomic nervous system. This includes postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, mitral valve prolapse dysautonomia, pure autonomic failure, multiple system atrophy (Shy-Drager syndrome), and a number of lesser-known disorders. This article is in need of attention from an expert on the subject. ... Postural orthostatic tachycardia syndrome (or POTS) is a condition of orthostatic intolerance in which a change from the supine position to an upright position causes an abnormally-high increase in heart rate. ... Vasovagal syncope (also vasodepressor syncope or neurocardiogenic syncope) is the most common cause of fainting (syncope in medical terminology). ... Pure autonomic failure, also known as Bradbury-Eggleston syndrome or idiopathic orthostatic hypotension, is a form of dysautonomia that first occurs in middle age or later in life; men are affected more often than women. ... Multiple system atrophy (MSA) is a degenerative neurological disorder characterized by a combination of the following: Progressive damage to the autonomic nervous system, commonly leading to low blood pressure upon standing, difficulty urinating, and/or abnormal breathing during sleep Muscle rigidity +/- tremor and slow movement (Parkinsonism) Poor coordination / unsteady walking...

In some cases, dysautonomia results in a reduction in the ability of the heart and circulatory system to compensate for changes in posture, causing dizziness or syncope (fainting) when one, eg, stands suddenly. In other cases, the heart may race (tachycardia) for no apparent reason, or the kidneys may fail to properly retain water (diabetes insipidus). Syncope has two distinct and apparantly unrelated meanings, one in linguistics and another in medicne. ... Tachycardia is an abnormally rapid beating of the heart, defined as a resting heart rate of over 100 beats per minute. ... Diabetes insipidus (DI) is a disease characterized by excretion of large amounts of severely diluted urine, which cannot be reduced when fluid intake is reduced. ...

The effects of dysautonomia may be minor, only limiting the patient's activities slightly, or they may be totally disabling, leaving the patient bedridden. Chronic fatigue syndrome is often associated with dysautonomia. Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS) and various other names, is a syndrome of unknown and possibly multiple etiologies, affecting the central nervous system (CNS), immune, and many other systems and organs. ...

History

In the nineteenth and earlier twentieth centuries, a diagnosis that was almost solely given to women was called "neurasthenia," or a "weak nervous system." These women would present symptoms of fatigue, weakness, dizziness and fainting, and the doctor's orders would simply be bed rest. Some of these women died, while many others recovered. No one understood where the problems came from. Neurasthenia was a term first coined by George Miller Beard in 1869 to describe a condition with symptoms of fatigue, anxiety and pessimism. ...

Nowadays, diagnostic criteria and treatment for various forms of dysautonomia have sharpened, and doctors have realized that some men have it, too.

Treatment

There is no cure for dysautonomia. Secondary forms may improve with treatment of the underlying disease. In many cases treatment of primary dysautonomia is symptomatic and supportive. Measures to combat orthostatic hypotension include elevation of the head of the bed, frequent small meals, a high-salt diet, and drugs such as fludrocortisone, midodrine, and ephedrine.

Prognosis

The outlook for patients with dysautonomia depends on the particular diagnostic category. Patients with chronic, progressive, generalized dysautonomia in the setting of central nervous system degeneration have a generally poor long-term prognosis. Death can occur from pneumonia, acute respiratory failure, or sudden cardiopulmonary arrest in such patients.

References

• Dysautonomia Youth Network of America, Inc.
• National Dysautonomia Research Foundation (NDRF)
• Dysautonomia Information Network
• A family of misunderstood disorders, by Richard N Fogoros

External links

• Dysautonomia Youth Network of America, Inc. (DYNA)
• NINDS