Autonomic neuropathy
| Autonomic neuropathy | |
|---|---|
| Specialty | Neurology |
Autonomic neuropathy (AN or AAN) is a form of
diabetes mellitus
type 1 and 2. In most—but not all—cases, autonomic neuropathy occurs alongside other forms of neuropathy, such as sensory neuropathy.
Autonomic neuropathy is one cause of malfunction of the autonomic nervous system (referred to as
autonomic dysfunction, such as multiple system atrophy
, and therefore, may cause similar symptoms to autonomic neuropathy.
Signs and symptoms
The signs and symptoms of autonomic neuropathy include the following:[citation needed]
- urinary incontinence or urinary retention which happens due to the uncoordinated contraction of the bladder. Neurogenic bladder is a broad term used to describe this dysfunction.[1]
- Gastrointestinal tract: dysphagia, abdominal pain, nausea, vomiting, malabsorption, fecal incontinence, gastroparesis, diarrhea, constipation
- Cardiovascular system: disturbances of heart rate (tachycardia, bradycardia), orthostatic hypotension, inadequate increase of heart rate on exertion
- Respiratory system: impairments in the signals associated with regulation of breathing and gas exchange (central sleep apnea, hypopnea, bradypnea).[2]
- Nervous system: pupillary defect, exaggerated hippus, dizziness or lightheadedness.
- Other areas: impotence, sweat disturbances, sicca (dryness).
- Absence of signs of cerebellar dysfunction or parkinsonian symptoms as the presence of either would indicate the more serious disease of multiple system atrophy.
Causes
Many health conditions can cause autonomic neuropathy. Some common causes of autonomic neuropathy include:
- 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.
- Treatment with certain medications, including some drugs used in cancer chemotherapy.
- Abnormal protein buildup in organs (amyloidosis), which affects the organs and the nervous system.
- An abnormal attack by the immune system (autoimmune autonomic ganglionopathy), sometimes as part of a paraneoplastic syndrome which can occur even when cancer has not yet been diagnosed.
- Certain infectious diseases. Some viruses and bacteria, such as botulism, Lyme disease and HIV, can cause autonomic neuropathy.
- Inherited disorders. Certain hereditary disorderscan cause autonomic neuropathy.
- celiac disease. Guillain–Barré syndromeis an autoimmune disease that happens rapidly and can affect autonomic nerves.
Diagnosis
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Treatment
Neurogenic Bladder
Depending on the symptoms and severity of the dysfunction, the doctor might suggest one of the following treatments[3][4]
- Behavioral changes: such as reducing water intake, kegel exercises, biofeedback training
- Clean intermittent catheterization: insertion of a foley catheter to remove the urine every few hours and prevent retention, done in a sterilemanner.
- Pharmacological therapy, which includes anticholinergicdrugs which reduce the contraction of the bladder
- Botoxinjections into the bladder
- Surgical treatment: Urinary diversion, Artificial Urinary Sphincter, Urethral sling, or insertion of electrical devices adjacent to the bladder to stimulate its contraction.
References
- ^ "Neurogenic Bladder: Overview, Neuroanatomy, Physiology and Pathophysiology". 2019-12-05.
{{cite journal}}: Cite journal requires|journal=(help) - PMID 24095132.
- ^ "Neurogenic Bladder Management and Treatment". Cleveland Clinic. Retrieved 2020-03-08.
- ^ Urology, Weill Cornell (2017-11-16). "Neurogenic Bladder - Treatment Options". Weill Cornell Medicine: Department of Urology - New York. Retrieved 2020-03-08.