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Autonomic Function Tests: Some Clinical Applications

Modern autonomic function tests can non-invasively evaluate the severity and distribution of autonomic failure. They have sufficient sensitivity to detect even subclinical dysautonomia. Standard laboratory testing evaluates cardiovagal, sudomotor and adrenergic autonomic functions. Cardiovagal funct...

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Autores principales: Low, Phillip A., Tomalia, Victoria A., Park, Ki-Jong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurological Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543903/
https://www.ncbi.nlm.nih.gov/pubmed/23346153
http://dx.doi.org/10.3988/jcn.2013.9.1.1
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author Low, Phillip A.
Tomalia, Victoria A.
Park, Ki-Jong
author_facet Low, Phillip A.
Tomalia, Victoria A.
Park, Ki-Jong
author_sort Low, Phillip A.
collection PubMed
description Modern autonomic function tests can non-invasively evaluate the severity and distribution of autonomic failure. They have sufficient sensitivity to detect even subclinical dysautonomia. Standard laboratory testing evaluates cardiovagal, sudomotor and adrenergic autonomic functions. Cardiovagal function is typically evaluated by testing heart rate response to deep breathing at a defined rate and to the Valsalva maneuver. Sudomotor function can be evaluated with the quantitative sudomotor axon reflex test and the thermoregulatory sweat test. Adrenergic function is evaluated by the blood pressure and heart rate responses to the Valsalva maneuver and to head-up tilt. Tests are useful in defining the presence of autonomic failure, their natural history, and response to treatment. They can also define patterns of dysautonomia that are useful in helping the clinician diagnose certain autonomic conditions. For example, the tests are useful in the diagnosis of the autonomic neuropathies and distal small fiber neuropathy. The autonomic neuropathies (such as those due to diabetes or amyloidosis) are characterized by severe generalized autonomic failure. Distal small fiber neuropathy is characterized by an absence of autonomic failure except for distal sudomotor failure. Selective autonomic failure (which only one system is affected) can be diagnosed by autonomic testing. An example is chronic idiopathic anhidrosis, where only sudomotor function is affected. Among the synucleinopathies, autonomic function tests can distinguish Parkinson's disease (PD) from multiple system atrophy (MSA). There is a gradation of autonomic failure. PD is characterized by mild autonomic failure and a length-dependent pattern of sudomotor involvement. MSA and pure autonomic failure have severe generalized autonomic failure while DLB is intermediate.
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spelling pubmed-35439032013-01-23 Autonomic Function Tests: Some Clinical Applications Low, Phillip A. Tomalia, Victoria A. Park, Ki-Jong J Clin Neurol Review Modern autonomic function tests can non-invasively evaluate the severity and distribution of autonomic failure. They have sufficient sensitivity to detect even subclinical dysautonomia. Standard laboratory testing evaluates cardiovagal, sudomotor and adrenergic autonomic functions. Cardiovagal function is typically evaluated by testing heart rate response to deep breathing at a defined rate and to the Valsalva maneuver. Sudomotor function can be evaluated with the quantitative sudomotor axon reflex test and the thermoregulatory sweat test. Adrenergic function is evaluated by the blood pressure and heart rate responses to the Valsalva maneuver and to head-up tilt. Tests are useful in defining the presence of autonomic failure, their natural history, and response to treatment. They can also define patterns of dysautonomia that are useful in helping the clinician diagnose certain autonomic conditions. For example, the tests are useful in the diagnosis of the autonomic neuropathies and distal small fiber neuropathy. The autonomic neuropathies (such as those due to diabetes or amyloidosis) are characterized by severe generalized autonomic failure. Distal small fiber neuropathy is characterized by an absence of autonomic failure except for distal sudomotor failure. Selective autonomic failure (which only one system is affected) can be diagnosed by autonomic testing. An example is chronic idiopathic anhidrosis, where only sudomotor function is affected. Among the synucleinopathies, autonomic function tests can distinguish Parkinson's disease (PD) from multiple system atrophy (MSA). There is a gradation of autonomic failure. PD is characterized by mild autonomic failure and a length-dependent pattern of sudomotor involvement. MSA and pure autonomic failure have severe generalized autonomic failure while DLB is intermediate. Korean Neurological Association 2013-01 2013-01-03 /pmc/articles/PMC3543903/ /pubmed/23346153 http://dx.doi.org/10.3988/jcn.2013.9.1.1 Text en Copyright © 2013 Korean Neurological Association http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Low, Phillip A.
Tomalia, Victoria A.
Park, Ki-Jong
Autonomic Function Tests: Some Clinical Applications
title Autonomic Function Tests: Some Clinical Applications
title_full Autonomic Function Tests: Some Clinical Applications
title_fullStr Autonomic Function Tests: Some Clinical Applications
title_full_unstemmed Autonomic Function Tests: Some Clinical Applications
title_short Autonomic Function Tests: Some Clinical Applications
title_sort autonomic function tests: some clinical applications
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543903/
https://www.ncbi.nlm.nih.gov/pubmed/23346153
http://dx.doi.org/10.3988/jcn.2013.9.1.1
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