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Autonomic neuropathies are a group of disorders mostly affecting the lowly or unmyelinated autonomic nerve fibers that leads to autonomic disfunction . Since the dispersion of autonomic nerves is extensive , it involves the autonomic function of the cardiovascular , gastrointestinal , thermoregulatory , urogenital , sudomotor and pupillomotor system . The most coarse case of autonomic neuropathy in developed countries isdiabetes mellitus . Other condition that can lead to autonomic neuropathy let in amyloid deposition , infective diseases ( Chagas ’ disease , HIVneuropathy , botulism , leprosy , diphtheria ) , neurotoxic therapeutic drugs , certain hereditary stipulation ( Fabry ’s disease , Tangier disease , Triple - A syndrome , typewrite 2b multiple endocrine neoplasia , Navajo Indian neuropathy ) , immune - mediated andparaneoplastic syndrome.(1 )
How Long Will It Take To Recover From Autonomic Neuropathy?
Diabetic Autonomic Neuropathy
Autonomic Nervous System
The map of the autonomic nervous organisation is mainly to wield homeostasis in the body . It has parasympathetic and sympathetic branches that work face-to-face to each other to maintain homeostasis . The imbalance between these two systems lead to autonomic dysfunction . Although autonomic dysfunction is treatable , modern autonomic dysfunction can be operose to deal . The in the beginning the espial of autonomic dysfunction , easier is the direction . Unfortunately , the earlier detection of autonomic disfunction is not potential and therefore it is mostly diagnose at an advanced stage and at this stage only treatment of symptoms is possible.(2 )
How Long Do The Symptoms Last?
The basal objective lens of treating autonomic neuropathy is to first handle the treatable conditions . For example , if diabetes mellitus is the inherent cause , blood glucose control should be done to prevent further worsening of the symptom and if autoimmunity is the primary lawsuit , immunomodulatory drugs should be regard . Although most of the autonomic neuropathy can not be invert and can be a lifelong problem , the symptoms can be treated with various therapies.(3 )
For orthostatic intolerance , conservative management should be considered first , which includes a high inspiration of fluid and salt . It is note that the intake of 1 - 2 glass of water can have a significant effect on systolic blood pressure by increasing both descent volume and sympathetic activity . It is important to move bodily part and postures cautiously and slowly and avoidance of alcoholic is rede . patient role should be further to sit or lie down if orthostatic symptom go back . Compressive stocking are found beneficial along with different maneuvers , such as the crossing of legs , squatting , and tensing of leg muscles , abdominal muscles , buttocks or the whole trunk . Cases that are not manage with conservation treatment can be manage with pharmacological therapy such as beta - blockers , volume enlargement with fludrocortisone or vasoconstriction with alpha - sympathomimetic agonist midodrine.(3 )
Bladder dysfunction can be oversee with strict mobile schedule , bladder training , and medication such as oxybutynin , tolterodine , and bethanechol . For refractory character , intermittent catheterization or artificial sphincters may be required . Sexual dysfunction may be treated with sildenafil , tadalafil , and vardenafil.(3 )
Gastrointestinal condition can be dealt with dietary change , low frequent meals , increase fiber ingestion and increased runny intake . Hyposalivation can be managed with pyridostigmine , whereas , modify taste whizz can be managed with cyproheptadine . Patients with deficiency of lather should be train on the jeopardy of heatstroke and should be secern to forefend extravagant and prolong heat exposure . In affected role with extravagant sweat discharge , botulinum toxin can be used for focal hyperhidrosis ; anticholinergic drug ( amitriptyline hydrochloride , glycopyrrolate , scopolamine patch , hyoscyamine and belladonna tincture ) can be used for generalized symptoms .
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