Autonomic Neuropathy

Written by Suzanne Allen and Marijane Leonard | Published on August 16, 2012
Medically Reviewed by George Krucik, MD

Overview

Autonomic neuropathy (AN) is a condition that results from damage to nerves that assist in organ and organ system functioning. This nerve damage disturbs signal processing between the autonomic nervous system and the brain. When your autonomic nerves are injured, your blood pressure, heart rate, perspiration patterns, bowel movement, bladder emptying, and digestion may be affected.

AN is often a complication associated with other medical conditions and diseases and certain medications. Your symptoms may vary based on the cause of your neuropathy and the location of your nerve damage.

Causes

Factors that might cause injury to the autonomic nerves include:

  • alcoholism
  • diabetes
  • chronic illnesses, such as HIV or Parkinson’s disease
  • medication, such as chemotherapy drugs
  • nerve trauma, such as bruise, burn, or cut
  • atypical protein buildup in the organs
  • autoimmune disorders, such as lupus
  • degenerative disorders, such as multiple system atrophy

Risk Factors

Some factors that may increase your risk of AN include diabetes, alcoholism, or other medical conditions, such as lupus, HIV, Parkinson’s disease, botulism, and cancer.

If you have diabetes, being overweight, elderly, and having high blood pressure and high cholesterol may further increase your risk of developing AN.

Symptoms

AN can affect many organs and cause an array of symptoms. Some early symptoms of AN include:

  • dizziness or faintness when rising or standing
  • vomiting or feeling nauseated when eating
  • disturbances with bowel movements, bladder control, or sexual functioning

More progressive symptoms may affect specific organ functioning. These include:

Bladder

  • urinary incontinence
  • inability to empty the bladder
  • frequent urinary tract infections

Digestive System

  • frequent indigestion or heartburn
  • vomiting undigested food
  • diarrhea
  • swollen abdomen
  • constipation
  • full feeling after eating a small quantity of food
  • poor appetite

Sex Organs

  • erectile dysfunction
  • premature ejaculation
  • in women, a difficulty in achieving an orgasm
  • vaginal dryness

Heart and Blood Vessels

Eyes

  • slow pupil adjustment from dark to light
  • difficulty driving at night

Sweat Glands

  • excessive sweating
  • no sweating when you are hot
  • dry skin on your feet

Other Symptoms

  • unexplained weight loss
  • no warning signals of low blood glucose, such as shakiness

Tests and Diagnosis

Call for an appointment with your physician if you have symptoms of AN. Early diagnosis may improve your prognosis.

Your doctor will make a diagnosis based on your risk factors, observations during a physical examination, and results of medical tests. Your physician may conduct the following tests:

  • breathing tests to evaluate blood pressure and heart rate
  • gastric-emptying tests to observe gastric motility and muscle activity
  • quantitative sudomotor axon reflex test to assess nerve reactions associated with the sweat glands
  • blood pressure when standing and sitting
  • tilt-table test to monitor blood pressure during posture changes
  • thermoregulatory test to observe sweat patterns during temperature changes
  • urine tests to assess bladder functioning
  • bladder ultrasound to view the bladder structure
  • abdominal X-rays to examine the digestive tract

Treatments

Treatments for AN target the damaged nerves and any underlying condition causing injury to the nerves. Thus, different treatments are available depending on the symptoms you are experiencing.

Digestive and gastrointestinal treatments include:

  • taking prescription medications, such as metoclopramide, to aid digestion
  • taking medications, such as laxatives, for constipation
  • consuming frequent, small meals
  • increasing fiber and fluid intake
  • taking tricyclic antidepressants for stomach pain or loose stools

Bladder and urinary treatments include:

  • taking prescription medication, such as bethanechol, to empty your bladder
  • taking prescription medication, such as oxybutynin, to reduce symptoms of overactive bladder
  • scheduling your drinking and urinating to retrain your bladder
  • threading a catheter through the urethra to drain the bladder

Sexual dysfunction treatments include:

  • taking medication to induce erection, such as sildenafil
  • using a vacuum pump to force blood into the penis to induce an erection
  • using vaginal lubricants to combat dryness

Heart and blood pressure treatments include:

  • consuming a high-sodium and high-fluid diet to sustain blood pressure
  • taking prescription medication, such as fludrocortisone acetate, to reduce dizziness when rising
  • taking prescription medication, such as midodrine, to increase your blood pressure for faintness
  • taking beta blockers to regulate your heart rate with differing activity levels
  • changing your posture, flexing your feet and slowing your speed when rising to decrease dizziness
  • sleeping with your head elevated to reduce dizziness

Abnormal sweating treatment includes:

  • taking prescription medication, such as glycopyrrolate, to reduce excessive sweating

Prognosis

The prognosis varies based on what is causing the nerve damage and how well it can be treated. In some cases, the nerves can repair themselves. In others, symptoms remain the same or even worsen despite treatment.

Prevention

Addressing conditions that may cause neuropathy might help prevent its development.

Keep your blood sugar stable if you have diabetes. Eating a low-sugar and high-fiber diet might help regulate diabetes.

Stop smoking cigarettes. Talk to your physician about treatments available to assist in quitting.

Stop drinking alcohol. Seeking the services of a counselor may be helpful.

Incorporate exercise into your daily life to help you lose weight and manage certain health conditions.

Prevent high blood pressure by drinking plenty of fluids, exercising regularly, and eliminating stressors.

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