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Autonomic Failure Syndrome (Pure Autonomic Failure)

Zaiba Jetpuri, MBA, FAAFP, DO and Haneen Abdelkhaleq, DO Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Degenerative disorder of the peripheral autonomic nervous system and considered to be one of the Lewy body diseases  (1)[C],(2)[C]

  • Blood pressure (BP) drops with inadequate compensato...

DIAGNOSIS

HISTORY

  • Dizziness or near syncope within seconds after standing, after a large meal (especially carbohydrate heavy), or in hot weather (3)[C]

  • Hypertension when lying flat (3)[C]

  • Neck pain in ...

TREATMENT

GENERAL MEASURES

  • Encourage physical exercise; change positions slowly, and avoid immobility.

  • Consider compression stockings waist or thigh high of 30–40 mm Hg, abdominal binder  (1,2)[C],(3)[...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Work with primary care doctor to achieve symptom control and functional improvement. 

Patient Monitoring

Monitor for signs of weakness and light-headedness at home....

REFERENCES

1
Brown  TP. Pure autonomic failure. Pract Neurol.  2017;17(5):341–348. [View Abstract on OvidMedline]
2
Thaisetthawatku...

ADDITIONAL READING

Shibao C, Okamoto L, Biaggioni I. Pharmacotherapy of autonomic failure. Pharmacol Ther. 2012;134(3):279–286.  

CODES

ICD10

G90.8 Other disorders of autonomic nervous system 

SNOMED

  • 84438001 Pure autonomic failure

  • 15241006 Disorder of autonomic nervous system

CLINICAL PEARLS

  • Orthostatic hypotension defined by systolic BP drop of >20 mm Hg or diastolic BP drop >10 mm Hg within 3 minutes of standing or head-up tilt test of at least 60-degree angle

  • PAF i...

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