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Neuropathy, Autonomic

Gregory John Ferenchak, MD and Shreyas Srinivasan, D.O Reviewed 06/2022
 


BASICS

DESCRIPTION

  • A peripheral neuropathy characterized by a broad array of disease processes that can alter the function of the autonomic nervous system (ANS)

  • Effects can be acute, subacute, or chroni...

DIAGNOSIS

HISTORY

Common symptoms include: (4
  • Orthostatic light-headedness or syncope

  • Early satiety, nausea, postprandial vomiting

  • Hyperhidrosis or anhidrosis

  • Gustatory (with meals) sweating

  • Constipation...

TREATMENT

GENERAL MEASURES

  • "Three Pillars" of treating autonomic neuropathy include disease modifying therapy (when possible), dietary and behavioral changes, and symptomatic management (2).

  • For diabet...

ONGOING CARE

DIET

Dietary restrictions that contribute to diabetes mellitus and cardiovascular risk including high sugar, carbohydrate-rich food, and low sodium intake. To prevent delay of gastric empt...

REFERENCES

1
Azhary  H, Farooq  MU, Bhanushali  M, et al. Peripheral neuropathy: differential diagnosis and management. Am Fam Physician.  2010;81(7): 887–892. [View Abstra...

CODES

ICD10

  • G90.9 Disorder of the autonomic nervous system, unspecified

  • E11.43 Type 2 diabetes w diabetic autonomic (poly)neuropathy

  • E10.43 Type 1 diabetes w diabetic autonomic (poly)neuropathy

  • E13.43 Oth...

CLINICAL PEARLS

  • Autonomic effects are often subclinical in peripheral neuropathies.

  • A resting HR of >90 beats/min, especially if persistent, should increase concern for autonomic neuropathy.

  • Erectile...

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