Dysautonomias: Clinical Disorders of the Autonomic Nervous System

摘要: The term dysautonomia refers to a change in autonomic nervous system function that adversely affects health. changes range from transient, occasional episodes of neurally mediated hypotension progressive neurodegenerative diseases; disorders which altered plays primary pathophysiologic role it worsens an independent pathologic state; and mechanistically straightforward mysterious controversial entities. In chronic failure (pure failure, multiple atrophy, or Parkinson disease), orthostatic reflects sympathetic neurocirculatory denervation deranged reflexive regulation outflows. Chronic intolerance associated with postural tachycardia can arise cardiac activation after "patchy" impairment blood volume depletion or, as highlighted this discussion, abnormality augments delivery the neurotransmitter norepinephrine its receptors heart. Increased nerve traffic heart kidneys seems occur essential hypertension develops. Acute panic evoke coronary spasm is sympathoneural adrenomedullary excitation. congestive compensatory may chronically worsen myocardial function, rationalizes treatment beta-adrenoceptor blockers. A high frequency positive results on tilt-table testing has confirmed association between fatigue syndrome intolerance; however, salt-retaining steroid fludrocortisone, usually beneficial does not seem be syndrome. Dysautonomias are important subject clinical neurocardiology.