Dysautonomia: Diagnosis and Management

Alexandra Hovaguimian

doi:10.1016/j.ncl.2022.08.002

Dysautonomia: Diagnosis and Management

Neurol Clin. 2023 Feb;41(1):193-213. doi: 10.1016/j.ncl.2022.08.002. Epub 2022 Oct 31.

Author

Alexandra Hovaguimian¹

Affiliation

¹ Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, KS 432, Boston, MA 02215, USA. Electronic address: ahovagui@bidmc.harvard.edu.

PMID: 36400555
DOI: 10.1016/j.ncl.2022.08.002

Abstract

Dysautonomias are a heterogenous group of disorders that can cause variable symptoms ranging from isolated impairment of one autonomic function to multisystem failure. The causes are also diverse and can be central or peripheral and primary (owing to an intrinsic neurologic cause) or secondary (owing to a disorder that secondarily causes damage to the autonomic nervous system). This review covers common phenotypes of dysautonomias, primary and secondary causes, initial clinical workups, interpretation of common autonomic tests, and first-line treatments. A brief review of autonomic impairment associated with acute and long-COVID is also presented.

Keywords: Autonomic dysfunction; Autonomic nervous system; Autonomic neuropathy; Autonomic testing; Dysautonomia; Neurogenic orthostatic hypotension; Postural orthostatic tachycardia syndrome; Tilt table testing.

Publication types

Review

MeSH terms

COVID-19*
Humans
Post-Acute COVID-19 Syndrome
Primary Dysautonomias* / diagnosis
Primary Dysautonomias* / etiology
Primary Dysautonomias* / therapy