Dysautomomia

What is dysautonomia?

Dysautonomia is a general term to describe a variety of conditions related to dysfunction of the autonomic nervous system (ANS). It may be hyper-activity or under activity of either the sympathetic (fight or flight) or parasympathetic (rest and digest) system. The ANS is involved in the automatic control of primitive functions such as heart rate, blood pressure, temperature, respiration rate, sweating, and thousands of other functions that do not require our conscious control. There may be varied causes for dysautonomia which include auto-immunity reactions, sensory small fiber neuropathy, neuro-degenerative disease and brain injury (1, 2).

The symptoms can be highly varied and may be isolated to a particular body part like a finger, or can be very generalized due to failure to maintain systemic blood flow. When the problem affects one’s brain there can be a constellation of symptoms depending on which parts of the brain are involved.

 

What are the more common types of dysautonomia?

Dysautonomia translates to poor function or the autonomic nervous system, therefore, it’s a very broad term that refers to many different presentations. Symptoms and severity varies widely. We will discuss a few of the more common presentations here. Call our office at 770-485-6554 if you would like information about your type of dysautonomia.

Neurocardiogenic syncope (NCS) is the most common form of dysautonomia. It is a failure of the nervous system to maintain a steady and appropriate heart rate and rhythm. It results in fainting sometimes multiple times a day.

Another common and very debilitating type of dysautonomia that is a type of orthostatic hypotension known as POTS (postural orthostatic tachycardia syndrome). People living with POTS have a brain that has lost its ability to regular the blood flow in their bodies. They may experience blood pooling in their limbs and therefore have trouble with positional changes (such as going from sitting to standing, or lying down to sitting). Click here (LINK) to learn more about POTS.

There are several other types of dysautonomia; two of which are complex regional pain syndrome type I (previously known as reflex sympathetic dystrophy (RSD)), and type II which occurs secondary to a direct injury to a nerve (previously known as causalgia). Some additional forms of dysautonomia are secondary to other conditions, such as the rare and debilitating Multiple Systems Atrophy (MSA) (1).

How is dysautonomia typically diagnosed?

The diagnosis of dysautonomia is typically treated based upon your symptomatology. For example, if it appears that your heart is being affected because you’re dizzy or have an elevated or depressed heart rate, you will be sent to a cardiologist. If your doctor suspects you are having trouble with orthostatic intolerance (standing to sitting, for example), then you will be monitored under positional changes looking for changes in your blood pressure. If you have severe pain in a limb, you will be sent to a pain specialist. The commonality between these cases is that providers are looking at the body parts, organs, systems and regions that are affected by your dysfunctional autonomic nervous system. But there’s a missing piece to the puzzle that can play a very important role. Far too often, the brain (the main controller of your autonomic nervous system) is not  thoroughly investigated.

Sad skinny anorectic girl and bottle of water

How is dysautonomia typically treated?

Dysautonomia, in its many forms, is typically treated symptomatically, meaning medications are typically used to diminish the pain or dysfunction.

How does Innova get to the root of the problem?

We look at each of the puzzle pieces: the brain, the remainder of the autonomic nervous system, as well as the affected organs and body systems that are leading to your symptoms. We systematically test and monitor all of these factors to discover how your brain function plays a role in your condition. Our doctors examine you head to toe and run diagnostic testing to look for abnormal function of the brain stem, cerebellum, cerebral cortex, spinal cord, and deep brain structures to discover where your deficits may lie. You may have dizziness when you change positions and it has been found that your heart rate increases with positional changes.  Your rapid heart rate leads to dizziness, but why does your heart rate increase in the first place? These are the questions we investigate at Innova Brain. If you’ve had the traditional testing performed for dysautonomia and are still struggling with symptoms, it’s time for a closer look.

How does Innova treat dysautonomia?

Our diagnosis process provides us with an accurate understanding of what areas of the brain are not functioning. This allows us to develop a more precise plan of targeted and appropriate rehabilitation.

Our doctors are trained to select the most appropriate type and amount of stimulation that targets the affected neurons so that they are able to rebuild or reprogram the failing structures. Just as we see with young children, movement, sound, and visual stimulation are sought out by them to drive their brains to grow and learn, we use these modalities and more at Innova for restoration of normal brain function. This simple concept of stimulating the brain by specifically prescribed activities and treatments causes the brain to grow healthy, functional, connections, and in essence rewire itself.

There are thousands of types and combinations of therapies that can be used to assist the brain in repairing it’s autonomic function. The rehabilitation protocol that you will receive will be based on your precise needs. It may come in many different forms. Exercises that call for head movements which involve specific eye activities or a stimulation that is created by patterns of movement on a computer screen are a couple of examples of what may be most appropriate for a particular patient’s needs. Whole body rotational therapy in select cases may be used to create robust stimulation for the vestibular system which is “hard wired’ to many other body systems like your digestive system, e.g., that is how too much motion can make you nauseated. Years of training and experience by our doctors allow them to make the best and safest choices for you to begin your recovery process.

Are you a good candidate for treatment here?

If you feel like you’ve slipped through the cracks, we suggest you schedule a phone or in-person consultation. After a consultation we will have a better idea if we can help.

Patients that are vetted by the consultation process, then go through the examination and diagnostics process to search for distinct areas of brain dysfunction that we refer to as bio-markers. Your next step is trialing very tailored and targeted sensory stimulation to the brain to show a distinct change.  If the bio-markers can be changed in a positive direction, then we have a higher expectation that your nervous system is responsive. This means that your brain has a greater probability of reprogramming itself and relieving you of your condition. It is our goal to help you resume a normal lifestyle, and we only accept patients for care who we sincerely believe can accomplish that goal.

References

  1. Rajput A.H., Rozdilsky B, Dysautonomia in Parkinsonism: a clinicopathological study, Journal of Neurology, Neurosurgery and Psychiatry, Vol. 39, Issue 11.
  2. Baguleya I.J., Nichollsa J.L., Felminghama K.L., Crooksa J., Gurkaa J.A., Wadea D., Dysautonomia after traumatic brain injury: a forgotten syndrome? Journal of Neurology, Neurosurgery and Psychiatry, Vol. 67, Issue 1.

Additional Resources

Dysautonomia, National Institute of Neurological Disorders and Stroke

What is Dysautonomia?, Dysautonomia International

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