Autonomic Disorders

Autonomic disorders refer to the part of our nervous system that we don’t consciously control or really think about. They are nerve disorders that affect involuntary body functions, including heart rate, blood pressure, sweat and digestion. Autonomic disorders can be caused by a large number of diseases and conditions or can be a side effect of treatment for diseases unrelated to the nervous system.

Autonomic Conditions We Treat:

  • Autonomic failure
  • Orthostatic hypotension
  • Orthostatic intolerance
  • Autonomic and small fiber neuropathy
  • Postural orthostatic tachycardia syndrome (POTS)
  • Sweat disorders, such as anhidrosis and hyperhidrosis
  • Certain degenerative diseases, such as multiple system atrophy and autonomic failure in Parkinson's disease

Symptoms of an Autonomic Disorder

Signs and symptoms of autonomic disorders vary, depending on which parts of your autonomic nervous system are affected. They may include:

  • Dizziness and fainting upon standing, caused by a drop in blood pressure
  • Urinary problems, an inability to completely empty your bladder and urinary tract infections
  • Sexual difficulties, including problems achieving or maintaining an erection or ejaculation problems in men and vaginal dryness and difficulties with arousal and orgasm in women
  • Difficulty digesting food, due to abnormal digestive function and slow emptying of the stomach. (This can cause a feeling of fullness after eating little, loss of appetite, diarrhea, constipation, abdominal bloating, nausea, vomiting, difficulty swallowing and heartburn.)
  • Sweating abnormalities, such as excessive or decreased sweating, which affects the ability to regulate body temperature
  • Sluggish pupil reaction, making it difficult to adjust from light to dark and causing problems with driving at night
  • Exercise intolerance, which may occur if your heart rate remains unchanged instead of appropriately increasing and decreasing in response to your activity level

Advanced Diagnosis of Autonomic Disorders

It is very important to accurately diagnose the symptoms of an autonomic disorder. This is accomplished by a physical examination focused on the autonomic nervous system and a careful review of your medical history. Special testing of the autonomic nervous system may be conducted to:

  • Assess how well your autonomic nervous system controls blood pressure
  • Determine your heart rate during different maneuvers and deep breathing exercises
  • Measure the volume of sweat you produce
  • Measure your ability to feel vibration and temperature sensation

Autonomic testing is designed to determine how well your body is regulating blood pressure, heart rate and other functions of multiple organ systems, controlled by the autonomic nervous system. Our comprehensive tests include:

  1. Deep breathing. Tests the autonomic function of the cardiorespiratory system, predominately the cardiac parasympathetic system.
  2. Valsalva Maneuver. Tests the autonomic function of the cardiac sympathetic and parasympathetic system, and the vasomotor sympathetic and parasympathetic system.
  3. The Tilt Table Test. Tests for cardiac sympathetic and parasympathetic system, and the vasomotor sympathetic and parasympathetic system.
  4. Quantitative Sudomotor Axon Reflex Test (QSART). Tests the sudomotor sympathetic system in four sites.
  5. Thermoregulatory Sweat Testing (TST): Tests the whole sudomotor system.
  6. Infrared Dynamic Pupillometry (IDP) – Tests the integrity of the sympathetic and parasympathetic branches of the ANS at the pupil of the eye.
  7. Laser Doppler Flowmetry (LDF) – Tests the subcutaneous blood flow through small-sized arteries and the capillary system, under the influence of the autonomic nervous system.

Treating Autonomic Disorders at Sentara

We deliver highly personalized care based on the specifics of your autonomic disorder. Our team works together in providing you expert diagnosis and a treatment plan customized to your symptoms. Sometimes the underlying cause might be a medical condition. For example, if the underlying cause is diabetes, you'll need to control your blood sugar to keep it as close to normal as possible. Treating the underlying disease can help stop a