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The Veterinary Record Dec 2020Dysautonomia is a disease characterised by degeneration of autonomic neurons.
BACKGROUND
Dysautonomia is a disease characterised by degeneration of autonomic neurons.
METHODS
The aim of this study was to perform a retrospective multicentre review of clinical data relating to cats and dogs diagnosed with dysautonomia and to evaluate their outcome.
RESULTS
Cats (n=34) and dogs (n=19) with clinical signs consistent with dysautonomia were considered for this retrospective study. Reported clinical findings included oesophageal and gastrointestinal dysmotility and distension, urinary retention, reduced or absent tear production, third eyelid protrusion and inappropriate mydriasis. Treatment was supportive and included gastrointestinal prokinetics, feeding tube placement (oesophageal and percutaneous endoscopic gastrostomy tubes) and medications to treat urinary retention. The survival to discharge was 29 per cent in cats and 47 per cent in dogs. The overall survival in cats was 21 per cent and that in dogs was 32 per cent. Survival of greater than 2 years was seen in six cats and in three dogs.
CONCLUSION
This paper illustrates that some animals are able to survive this disease and can have a good long-term prognosis, which is an infrequently reported finding for this disease.
Topics: Animals; Autopsy; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Male; Primary Dysautonomias; Retrospective Studies; Survival; Treatment Outcome; United Kingdom
PubMed: 32253356
DOI: 10.1136/vr.105258 -
Current Opinion in Neurology Dec 2019Between 1.6 and 3.6 million concussions, or mild traumatic brain injuries (mTBI), occur each year, nearly half of which go unreported and untreated. Despite the high... (Review)
Review
PURPOSE OF REVIEW
Between 1.6 and 3.6 million concussions, or mild traumatic brain injuries (mTBI), occur each year, nearly half of which go unreported and untreated. Despite the high incidence, practitioners currently lack both objective gold-standard diagnostic tools and evidence-based treatments to enable optimal care of concussed individuals.
RECENT FINDINGS
This article aims to review recent research on the topic, emphasizing the role of the autonomic nervous system (ANS) in concussion. Current data suggests that ANS dysfunction is often evident following mTBI and accounts for many of the symptoms commonly seen in concussed patients. This link suggests several objective biomarkers that could be used to diagnose and monitor recovery following mTBI. Contrary to conventional wisdom, symptoms and biomarkers of ANS function improve when individuals are exposed to a program of graded exercise as treatment within the first week following concussion.
SUMMARY
ANS dysfunction contributes to concussion symptomatology, an effect likely mediated through diffuse axonal injury, including brainstem structures and pathways mediating normal cerebrovascular autoregulation. Exercise, which enhances ANS function, is a well tolerated and effective method of treatment for both acute concussion patients and those suffering from postconcussion syndrome (PCS). The relationship between the ANS, exercise, and concussion creates an opportunity for the identification of objective biomarkers that can facilitate the diagnosis and treatment of mTBI.
Topics: Autonomic Nervous System Diseases; Brain Concussion; Exercise Therapy; Humans
PubMed: 31567549
DOI: 10.1097/WCO.0000000000000751 -
Lancet (London, England) Aug 2023
Topics: Humans; Post-Acute COVID-19 Syndrome; COVID-19; Venous Insufficiency; Primary Dysautonomias
PubMed: 37573078
DOI: 10.1016/S0140-6736(23)01461-7 -
Handbook of Clinical Neurology 2023The autonomic nervous system (ANS) coordinates multiple reflex actions which are essential for life. The tests employed to evaluate the ANS provide valuable information... (Review)
Review
The autonomic nervous system (ANS) coordinates multiple reflex actions which are essential for life. The tests employed to evaluate the ANS provide valuable information of the functional state of these reflex arcs. The ideal test should be simple to perform, noninvasive, reproducible, sensitive, specific, safe, and appropriate for longitudinal studies. The availability of computer-based techniques has facilitated the electrophysiological assessment of ANS-mediated reflexes. The information provided by autonomic testing must be analyzed in combination with the clinical history and physical examination of the patient, allowing for a hypothesis that can be tested. Properly performed and interpreted, ANS testing can be used to confirm the presence of an ANS disturbance and the involved functional pathways, as well as the extent, intensity, and site of injury. This chapter describes the most important electrophysiological tests used to evaluate the ANS control of cardiovascular reflexes and sweat gland activity.
Topics: Humans; Autonomic Nervous System Diseases; Autonomic Nervous System; Reflex
PubMed: 37562875
DOI: 10.1016/B978-0-323-98818-6.00015-7 -
Seminars in Neurology Oct 2020
Topics: Humans; Primary Dysautonomias
PubMed: 33111287
DOI: 10.1055/s-0040-1718539 -
Acta Neurologica Belgica Aug 2022Autonomic dysfunction in patients with viral infections has been described before. In this study, we aimed to evaluate autonomic functions in patients with the...
PURPOSE
Autonomic dysfunction in patients with viral infections has been described before. In this study, we aimed to evaluate autonomic functions in patients with the coronavirus infectious disease 2019 (COVİD-19).
METHODS
In this cross-sectional study, we compared 112 patients who had recovered from COVID-19 and 106 healthy controls. Symptoms of autonomic dysfunction were assessed with the SCOPA-AUT scale.
RESULTS
Pupillomotor, urinary and sudomotor subscores of SCOPA-AUT scale were significantly higher in the COVID-19 patient group (p = 0.03, p = 0,006, p = 0.0001, respectively). There were no significant difference in terms of gastrointestinal, cardiovascular, sexual subscores and total SCOPA-AUT scores between the patient and control groups. The presence of fatigue symptom in the acute phase of COVID-19 increased the total SCOPA-AUT score by 2.2 points (p = 0.04) whereas the presence of smell loss (OR = 5.82, p = 0.01) and dyspnea (OR = 5.8, p = 0.03) were significant risk factors for pupillomotor dysfunction. The urinary, cardiovascular, sexual subscores and the total score of SCOPA-AUT scale were positively correlated with the age of the patient group.
CONCLUSION
Our study suggests that many patients might have prolonged symptoms of autonomic dysfunction after the acute phase of COVID-19 that might worsen the clinical recovery.
Topics: Autonomic Nervous System Diseases; COVID-19; Communicable Diseases; Cross-Sectional Studies; Humans; Surveys and Questionnaires
PubMed: 35239131
DOI: 10.1007/s13760-022-01899-z -
Parkinsonism & Related Disorders Aug 2020
Review
Topics: Amyloidosis; Autonomic Nervous System; Autonomic Nervous System Diseases; Humans; Male; Middle Aged; Multiple System Atrophy; Parkinsonian Disorders; Primary Dysautonomias
PubMed: 31097298
DOI: 10.1016/j.parkreldis.2019.05.005 -
Nature Reviews. Neurology Dec 2021Epileptic networks are intimately connected with the autonomic nervous system, as exemplified by a plethora of ictal (during a seizure) autonomic manifestations,... (Review)
Review
Epileptic networks are intimately connected with the autonomic nervous system, as exemplified by a plethora of ictal (during a seizure) autonomic manifestations, including epigastric sensations, palpitations, goosebumps and syncope (fainting). Ictal autonomic changes might serve as diagnostic clues, provide targets for seizure detection and help us to understand the mechanisms that underlie sudden unexpected death in epilepsy (SUDEP). Autonomic alterations are generally more prominent in focal seizures originating from the temporal lobe, demonstrating the importance of limbic structures to the autonomic nervous system, and are particularly pronounced in focal-to-bilateral and generalized tonic-clonic seizures. The presence, type and severity of autonomic features are determined by the seizure onset zone, propagation pathways, lateralization and timing of the seizures, and the presence of interictal autonomic dysfunction. Evidence is mounting that not all autonomic manifestations are linked to SUDEP. In addition, experimental and clinical data emphasize the heterogeneity of SUDEP and its infrequent overlap with sudden cardiac death. Here, we review the spectrum and diagnostic value of the mostly benign and self-limiting autonomic manifestations of epilepsy. In particular, we focus on presentations that are likely to contribute to SUDEP and discuss how wearable devices might help to prevent SUDEP.
Topics: Anticonvulsants; Autonomic Nervous System Diseases; Death, Sudden; Epilepsy; Humans; Sudden Unexpected Death in Epilepsy; Wearable Electronic Devices
PubMed: 34716432
DOI: 10.1038/s41582-021-00574-w -
Seminars in Neurology Oct 2020Investigations of the cellular and molecular mechanisms that mediate the development of the autonomic nervous system have identified critical genes and signaling... (Review)
Review
Investigations of the cellular and molecular mechanisms that mediate the development of the autonomic nervous system have identified critical genes and signaling pathways that, when disrupted, cause disorders of the autonomic nervous system. This review summarizes our current understanding of how the autonomic nervous system emerges from the organized spatial and temporal patterning of precursor cell migration, proliferation, communication, and differentiation, and discusses potential clinical implications for developmental disorders of the autonomic nervous system, including familial dysautonomia, Hirschsprung disease, Rett syndrome, and congenital central hypoventilation syndrome.
Topics: Autonomic Nervous System; Autonomic Nervous System Diseases; Dysautonomia, Familial; Hirschsprung Disease; Humans; Hypoventilation; Rett Syndrome; Sleep Apnea, Central
PubMed: 32927484
DOI: 10.1055/s-0040-1713926 -
Continuum (Minneapolis, Minn.) Feb 2020Autonomic disorders offer a fascinating view of the complexity of the nervous system. Their impact on human health ranges from benign to severe. Deciphering autonomic... (Review)
Review
PURPOSE OF REVIEW
Autonomic disorders offer a fascinating view of the complexity of the nervous system. Their impact on human health ranges from benign to severe. Deciphering autonomic symptoms and signs draws on the cognitive skills and personal interest in the plight of patients that first attracted many physicians to the field of neurology. This article provides tools to sharpen those skills.
RECENT FINDINGS
Autonomic neuroscience and accumulated clinical knowledge have led to the categorization of autonomic disorders into specific syndromes that can be identified on the basis of clinical phenotypes and physiologic responses to standardized stimuli in the autonomic laboratory. A key development has been the ability to distinguish neurogenic orthostatic hypotension from other causes of hypotension. Quantification of sudomotor responses has proven valuable in the diagnosis of thermoregulatory disorders and small fiber neuropathies such as those related to diabetes mellitus. Increasing attention has focused on autonomic failure as a defining feature of neurodegenerative α-synucleinopathies, especially multiple system atrophy. As awareness of autonomic disorders has increased, the once obscure term dysautonomia has entered into common parlance.
SUMMARY
With appropriate knowledge and experience, neurologists can diagnose autonomic dysfunction accurately and with confidence. The opportunity to play an important role in caring for patients with autonomic disorders is worth the effort.
Topics: Adult; Autonomic Nervous System; Autonomic Nervous System Diseases; Diagnostic Techniques, Neurological; Female; Humans; Male; Middle Aged
PubMed: 31996620
DOI: 10.1212/CON.0000000000000815