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

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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