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Neuropathy, Autonomic

Robert Baldor, md Reviewed 05/2023
 


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: 
  • Orthostatic light-headedness or syncope

  • Early satiety, nausea, postprandial vomiting

  • Hyperhidrosis or anhidrosis

  • Gustatory (with meals) sweating

  • Constipation or d...

TREATMENT

GENERAL MEASURES

  • "Three Pillars" of treating autonomic neuropathy include disease modifying therapy (when possible), dietary and behavioral changes, and symptomatic management (1).

  • 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
Kaur D, Tiwana H, Stino A, et al. Autonomic neuropathies. Muscle Nerve. 2021;63(1):10–21. doi: 10.1002/mus.27048
2
Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic neuropathy: a position...

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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