Autonomic Disorders

Autonomic disorders cause a wide variety of symptoms including orthostatic dizziness or fainting, nausea or vomiting especially with meals, diarrhea or constipation, dry eyes and mouth, urinary incontinence, sexual dysfunction, and changes in sweating, skin temperature, or color. Neurodegenerative autonomic disorders arise from degeneration of autonomic structures either in the central or peripheral nervous systems (e.g. multiple system atrophy, autonomic neuropathy). Syndromic or “benign” autonomic disorders are not associated with any known neurodegeneration, but still cause autonomic symptoms (e.g. neurocardiogenic syncope or postural orthostatic tachycardia syndrome (POTS)). This chapter addresses the signs and symptoms of autonomic dysfunction and reviews diagnostic evaluation and treatment.