Autonomic

Neuropathy
ALSANGEDY
 Generalized BULLETS
dysautonomia
 Sympathetic and
FOR PACES
FOR EASY PASSING PACES FROM
parasympathetic
THR 1ST ATTEMPT
dysfunction Dr. Ibrahim Alsangedy
 Orthostatic MRCP-UK
hypotension MRCPE

 Orthostatic
palpitations
 Facial pallor,
anhidrosis
 Reduced lacrimation

ALSANGEDY B ULLETS FOR PACES

 Episodic diarrhea
 Bowel incontinence
 Urinary incontinence
or urinary retention
 Impotence
 Visual disturbance
 Dysesthesia
 Hyperalgesia
Cause
 Diabetes mellitus
 Uremic neuropathy
 Amyloid neuropathy
 Postural orthostatic tachycardia
syndrome (POTS)
 Pandysautonomia
 Drug-induced autonomic
neuropathy
 Lyme disease
 HIV infection
 Paraneoplastic autonomic
neuropathy
Diagnosis
Differential Diagnosis
 Patient description and history
 Serum glucose level
 HbA1c
 Specific genetic tests for the
familial forms
 Specific tests for infections,
inflammatory, autoimmune,
and paraneoplastic causes
 Tilt table testing
 Quantitative Sudomotor Axon
Reflex Testing (QSART)
 Nerve conductions studies
 Electromyography (EMG)
Management
ALSANGEDY BULLETS FOR PACES
 The first objective of
management of a patient with
isangedy@gmail.com autonomic neuropathy is to treat
00965 69691034 the cause
Facebook page: - MRCP PACES
 Alpha-1 Agonists (Midodrine)
from the 1st attempt
Facebook group: - MRCP PACES  Mineralocorticoids
from the 1st attempt (Fludrocortisone)
 Anticholinergic (Oxybutynin)
 The treatment of patients with
orthostatic intolerance may
 Aromatic L-amino acid require a high-salt diet and high
decarboxylase deficiency fluid intake
 Autonomic dysreflexia syndrome
in spinal injuries.  Specific treatment related to the
 Dopamine beta-hydroxylase cause of autonomic neuropathy
deficiency
 Multiple System Atrophy
 Parkinson Disease
 Parkinson-Plus Syndromes
 Progressive Supranuclear Palsy
 Pure Autonomic Failure
 Surgical sympathectomy
 Syphilis (tabes dorsalis)
 Vagotomy