Autonomic Neuropathy Overview
What is autonomic neuropathy?
A person with autonomic neuropathy or ANS neuropathy syndrome has a group of symptoms, not a disease, that occur when there is damage to the nerves that run through the peripheral nervous system. This nerve damage affects the nerves responsible for the regulation of blood pressure, heart rate, digestion, and emptying of the bladder and bowels. Autonomic neuropathy may be an inherited (e.g. Fabry disease) or an acquired condition. In most cases, autonomic neuropathy develops in conjunction with another disease process. Diabetes is the most common cause of autonomic neuropathy. Other examples include Lyme disease, HIV infection, Chagas disease, botulism, diphtheria, leprosy, acute intermittent porphyria, end stage kidney disease, severe liver disease, lupus, rheumatoid arthritis, Guillain-Barre syndrome, inflammatory bowel disease, vitamin B12 deficiency, and chronic alcohol abuse. There are a large number of drugs, such as chemotherapy medications, that can cause a drug-related autonomic neuropathy.
What are the symptoms of autonomic neuropathy?
The symptoms of autonomic neuropathy usually develop gradually over years and include constipation, swollen abdomen, diarrhea, a full feeling after eating a small amount, nausea and vomiting, blood pressure changes, dizziness or faintness upon standing (orthostatic hypotension), urinating difficulty, and urinary incontinence. Other symptoms of autonomic neuropathy include vision changes, palpitations, tinnitus, headache, chest pain, shortness of breath, impotence, urinary frequency, bedwetting, urinary retention, and urinary incontinence. Other symptoms include burning feet, itching, numbness and tingling, dry skin, brittle nails, and cold feet.
How does the doctor treat autonomic neuropathy?
Treatment for autonomic neuropathy is directed at the underlying cause. Treatment for autonomic neuropathy often includes medications to help with salt and fluid retention, reduce postural hypotension, and increase fluid in the blood vessels. Treatment may also include sleeping with the head raised, the use of elastic stockings and eating small yet frequent meals.
Continue to Autonomic Neuropathy Symptoms
- Maser RE, Lenhard MJ. Cardiovascular autonomic neuropathy due to diabetes mellitus: clinical manifestations, consequences, and treatment. J Clin Endocrinol Metab. 2005 Oct;90(10):5896-903. Epub 2005 Jul 12. 
- Vinik AI, Ziegler D. Diabetic cardiovascular autonomic neuropathy. Circulation. 2007 Jan 23;115(3):387-97.