Understanding Dysautonomia: A Comprehensive Guide

TYPES OF DYSAUTONOMIA

Dysautonomias are a group of disorders that affect ANS. Researchers have identified at least 15 different types. The most common of them are pots and neurocardiogenic syncope.

●      POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME

Stats suggest that it affects nearly 1-3 million people in America. Dysautonomia with pots causes an abnormal increase in heart rate (40 bpm in teens, 30 bpm in adults) within 10 minutes of standing.

Pots symptoms appear in multiple organ systems and include tachycardia, chest pain, impaired thermoregulation, shortness of breath, dizziness, exercise intolerance, and many more. It is not a life-threatening disorder, but it can impact your quality of life.

Some scientific studies suggest that autoimmune disorders may be the underlying cause of dysautonomia pots. Autoimmune disorders are those in which the body attacks its own cells and tissue.

●      NEUROCARDIOGENIC SYNCOPE

Neurocardiogenic syncope, also known as vasovagal syncope, affects more than 10 million people worldwide. It causes a sudden drop in blood flow to the brain that causes syncope or fainting.

People with NCS may experience occasional or frequent fainting spills. It’s triggered by a long period of standing or sitting, emotional distress, alcohol, warm environment and dehydration. Avoiding these possible triggers may help patients with NCS who occasionally faint.

●      FAMILIAL DYSAUTONOMIA

It is also known as Riley-Day Syndrome. It is an uncommon genetic disorder that only affects 350 people all over the world. There is only a 25% chance that you will get this disease if both your parents are carriers.

Although it can affect people of any race, it most commonly occurs in Ashkenazi Jews. Familial dysautonomia symptoms include:

• Difficulty in swallowing
• Fluctuations in blood pressure
• Vision problems
• Respiratory and digestive complications
• Autonomic crisis (high blood pressure and heart rate followed by cyclic vomiting and retching)

●      BAROREFLEX FAILURE

Baroreflex is the body’s mechanism for regulating blood pressure. Baroreceptors detect high pressure in blood vessels and send signals to the brain via the baroreceptive nerves.

In baroreflex failure, damage to baroreflex structures occurs, and the brain doesn’t get information about blood pressure status. It causes the pressure to drop too low when a person is inactive or rises dangerously during stress.

Other symptoms include fluctuations in heart rate, headache, flushing, feeling of warmth and sweating.

●      AUTONOMIC DYSREFLEXIA

It is a disorder that affects people with spinal cord injuries. Greater the injury, the higher the risk of AD. Studies show that 90% of patients with cervical or thoracic spinal injury develop AD.

In autonomic dysreflexia, damaged spinal cord prevents the brain from receiving information which causes a sudden rise in blood pressure to a dangerous level. Other symptoms include throbbing headache, excessive sweating, flushing, nasal blockage, nausea, vomiting, and much more.

●      DIABETIC AUTONOMIC NEUROPATHY

As the name suggests, it’s the complication of diabetes. High Blood sugar levels damage the nerves that control gastrointestinal tract, heart, genitals, and many other organs. On average, about 20% of people with diabetes suffer from autonomic neuropathy.

Bladder paralysis is the most common symptom that appears in patients with DAN. It causes urine retention because nerves no longer respond to pressure in the bladder.

Other symptoms include

• Breathing problems
• Gastroparesis, a condition that affects the movement of the muscles in stomach
• Erectile dysfunction
• Increased heart rate
• Excess or no sweating at all
• Constipation
• Orthostatic hypotension

●      INAPPROPRIATE SINUS TACHYCARDIA

It is a rare form of dysautonomia that only affects 1.2% of the population. It’s a condition where a person’s resting heartbeat is above 100 bpm.

The word sinus refers to a normal rhythm. So in IST, a heart beats in its normal rhythm, but it just beats faster than usual. Symptoms include weakness, dizziness, fainting, exercise intolerance and shortness of breath.

●      MULTIPLE SYSTEM ATROPHY

MSA is a rare autonomic dysfunction that affects people above age 50. It is often misdiagnosed as Parkinson’s disease because of the common symptoms in the early stages. It has no specific cause, but scientific research shows that certain brain parts wear down in people with MSA.

On the basis of symptoms, multiple system atrophy is classified into two types. People with MSA-P have more parkinsonian-like symptoms that include:

• Difficulty swallowing
• Rigidity
• Resting Tremors
• Slow movements

In MSA-C, patients show predominant signs of cerebellar dysfunction that includes:

• Difficulty coordinating walking
• Poor hand coordination
• Slurred speech
• tremors

There’s no cure for MSA, and no treatment can slow down its progression. On average, 80% of patients get disabled within 5 years after the onset of motor symptoms.

●      PURE AUTONOMIC FAILURE

It is a peripheral neurodegenerative disorder of ANS. PAF, also known as Bradbury-Eggleston Syndrome, affects middle-aged people. It is more prevalent in men than women.

Synuclein is a protein that helps transmit nerve signals. PAF is thought to be caused by excessive accumulation of this molecule, as per mayo clinic research.  Progression of this disease leads to multiple system atrophy in some cases.

Symptoms of PAF include:

• Dizziness upon long periods of standing
• Raised blood pressure when lying down
• Persistent neck pain
• Decreased ability to sweat
• Constipation
• Heat intolerance

●      AUTOIMMUNE AUTONOMIC GANGLIONOPATHY

It is an autoimmune disorder where the body’s immune system attacks the receptors in autonomic ganglia. Autonomic ganglia is a cluster of nerve cell bodies in the autonomic nervous system.

When these receptors get damaged, the body doesn’t process information correctly. It leads to the impairment of some autonomic functions.

It’s a rare form of primary dysautonomia that only affects 100 Americans annually. People with AAG may experience a rapid onset or gradual presentation of symptoms. These include:

• Orthostatic hypotension
• Gastroparesis
• Urinary retention
• Fainting
• Dry eyes
• Dry mouth
• Dilated pupils