Autonomic Neuropathy entities: Difference between revisions

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=== Clinic ===
=== Clinic ===


* '''AN''' or '''AAN''' is a form of polyneuropathy that affects the non-voluntary, non-sensory nervous system (i.e., the autonomic nervous system)
* '''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 the genital organs.
* 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.
* Autonomic nerve fibers form large collections in the thorax, abdomen, and pelvis outside the spinal cord.
* They have connections with the spinal cord and ultimately the brain, however.
* Most commonly autonomic neuropathy is seen in persons with long-standing Diabetes mellitus type 1 and 2  
* Most commonly autonomic neuropathy is seen in persons with long-standing diabetes mellitus type 1 and 2. In most—but not all—cases,
* Autonomic neuropathy is one cause of Dysautonomia
* Autonomic neuropathy occurs alongside other forms of neuropathy, such as sensory neuropathy.
* Autonomic neuropathy is one cause of [[Autonomic dysfunction, Dysautonomia entities|Dysautonomia]]
* Some conditions affecting the brain or spinal cord also may cause autonomic dysfunction, such as [[MSA, Multiple system atrophy entitie|multiple system atrophy]], and therefore, may cause similar symptoms to autonomic neuropathy.
* Some conditions affecting the brain or spinal cord also may cause autonomic dysfunction, such as [[MSA, Multiple system atrophy entitie|multiple system atrophy]], and therefore, may cause similar symptoms to autonomic neuropathy.


=== Signs / Symptoms ===
=== Signs / Symptoms ===


* Urinary incontinence or Urinary retention: Neurogenic bladder is a broad term used to describe this dysfunction.
* 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
* 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
* Disturbances of heart rate (Tachycardia, Bradycardia), Orthostatic hypotension, Inadequate increase of heart rate on exertion
* Central sleep apnea,Hypopnea, Bradypnea
* [[Central sleep apnea]], Hypopnea, Bradypnea
* Pupillary defect, Exaggerated hippus, Dizziness or Light-headedness.
* Pupillary defect, [[Exaggerated hippus]], Dizziness or Light-headedness.
* Hypoglycemia unawareness, Genital impotence, Sweat disturbances, Sicca (dryness).
* Hypoglycemia unawareness
* Absence of signs of cerebellar dysfunction or parkinsonian symptoms as the presence of either would indicate the more serious disease of multiple system atrophy.
* [[Impotence]]
* [[Sjogren's syndrome|Sicca]]: Sweat disturbances,  
* [[Parkinsonism|Parkinsonian symptoms]]/ [[Multiple system atrophy]]


=== Causes ===
=== Causes ===

Latest revision as of 04:00, 4 May 2023

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) +++
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