Autonomic Neuropathies

The autonomic nervous system is involved in the most types of polyneuropathies but in some forms the autonomic dysfunctions may prevail. These are the acute pandysautonimia, the diabetic polyneuropathy, the acute Guillain-Barré syndrome, the amyloid polyneuropathy, the acute intermittent porphyria and the hereditary sensory autonomic neuropathy (HSAN). The clinical symptoms and signs are caused by dysfunctions of autonomic nerve fibers which accompany the somatic nerves as well by lesions of the visceral autonomic nerves. The following findings can be observed: Pupillary disorders, trophic disorders with ulcers, oedema and osteoarthropathy, hypo/anhidrosis, vasomotor disorders, cardio vascular dysfunstions with resting tachycardia, and decrease of heart rate variability, lack of reflectory hyperventilation, gastrointestinal disorders with diarrhoe or constipation, disorders of emptying the bladder and erectile dysfunction. Sequelae of afferent autonomic denervation abscence of pain in coronary ischiaemia abscence of perception and vegetative response to hyperglycaemia, faecal incontinence, lack of sensation for the filling of the bladder and abscence of labour pains. The therapy depends on the cause of the polyneuropathy. Sometimes symptomatic treatment ist possible.