Autonomic Neuropathy entities

Clinic

• AN or AAN is a form of polyneuropathy that affects the non-voluntary, non-sensory nervous system
• It affects mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract and genital organs.
• Autonomic nerve fibers form large collections in the thorax, abdomen, and pelvis outside the spinal cord.
• Most commonly autonomic neuropathy is seen in persons with long-standing Diabetes mellitus type 1 and 2
• Autonomic neuropathy is one cause of Dysautonomia
• Some conditions affecting the brain or spinal cord also may cause autonomic dysfunction, such as multiple system atrophy, and therefore, may cause similar symptoms to autonomic neuropathy.

Signs / Symptoms

• Urinary incontinence or Urinary retention: Neurogenic bladder is a broad term used to describe this dysfunction.
• Dysphagia, Abdominal pain, Nausea, Vomiting, Malabsorption, Fecal incontinence, Gastroparesis, Diarrhea, Constipation
• Disturbances of heart rate (Tachycardia, Bradycardia), Orthostatic hypotension, Inadequate increase of heart rate on exertion
• Central sleep apnea, Hypopnea, Bradypnea
• Pupillary defect, Exaggerated hippus, Dizziness or Light-headedness.
• Hypoglycemia unawareness
• Impotence
• Sicca: Sweat disturbances,
• Parkinsonian symptoms/ Multiple system atrophy

Causes

• Autoimmune disorders

• Diabetes, which is the most common cause of autonomic neuropathy, can gradually cause nerve damage throughout the body.

• Injury to nerves caused by surgery or radiation to the neck.
• Certain medications, including cancer chemotherapy.
• Amyloidosis, which affects nervous system.
• Neurodegenerative diseases including Parkinson's disease, MSA, Lewy body dementia and MS.
• Autoimmune autonomic ganglionopathy, sometimes as part of a paraneoplastic syndromes.
• Infections : Botulism, Lyme disease and HIV
• Inherited disorders. Certain hereditary disorders can cause autonomic neuropathy.
• Autoimmune diseases: Sjögren syndrome, SLE, RA, Celiac disease and Guillain–Barré syndrome

Entities

Note that ANN is not a single entity nor a complicated disease. It is a group of separated entities

	STLE	TBE	HTLV-1	HSV-1	HSV-2	EBV	PLV	RBS	LBB	VZV	CMV	SAHF
Urinary incontinence	+++	+++	+++						+
Urinary retention			+++	+++
Dysphagia
Ileus: Abdominal pain, Nausea, Vomiting, Malabsorption, Diarrhea, Constipation
Fecal incontinence				+++	+++						+++
Gastroparesis: Gasteric dilation							+++
Disturbances of heart rate (tachycardia, bradycardia) Orthostatic hypotension, Inadequate increase of heart rate on exertion		+++	+++	+++							+++	+++
Central sleep apnea, Hypopnea, Bradypnea								+++
Pupillary defect								+++
Exaggerated hippus
Dizziness or Light-headedness												+++
Hypoglycemia unawareness
Genital impotence			++	+++	+++				+
Sweat disturbances
Sicca (dryness)			+++