Autonomic neuropathy

Alternative names:

neuropathy - autonomic

Treatment:

Treatment is supportive. Treatment may need to be chronic and prolonged, and the response to treatment varies. Several treatments may be attempted before a treatment that is successful in reducing symptoms is identified.

The use of elastic stockings and sleeping with the head elevated may reduce postural hypotension. Fludrocortisone or similar medications may be beneficial in reducing postural hypotension for some people.

Medications that increase gastric motility (such as Reglan), use of small frequent meals, sleeping with the head elevated, or other measures may be used to treat reduced gastric motility.

Manual expression of urine (a technique in which the hands are used to compress the bladder), intermittent catheterization, or medications such as bethanechol may be necessary to treat bladder dysfunction.

Impotence, diarrhea, constipation, or other symptoms are treated as appropriate. These symptoms may respond poorly to treatment.

Expectations (prognosis):

The outcome varies. If the cause can be identified and treated, there is a chance that the nerves associated with autonomic neuropathy may repair or regenerate. The symptoms may reduce with treatment, or they may persist or worsen despite treatment. Most symptoms of autonomic neuropathy are uncomfortable but are seldom life threatening.

Complications:

• fluid or electrolyte imbalance such as hypokalemia (if excessive vomiting or diarrhea)
• malnutrition
• kidney failure (associated with reflux of urine)
• psychologic/social effects of impotence
• injuries from falls (associated with postural dizziness)

Calling your health care provider:

Call for an appointment with your health care provider if symptoms of autonomic neuropathy occur. Early diagnosis and treatment increases the likelihood of controlling symptoms.