Classification of Clinical Autonomic Disorders
- Autonomic disorders with brain involvement
- Associated with multisystem degeneration
- Multisystem degeneration: autonomic failure clinically prominent
- Multiple system atrophy
- Parkinson's disease with autonomic failure
- Diffuse Lewy body disease (some cases)
- Multisystem degeneration: autonomic failure clinically not usually prominent
- Parkinson's disease
- Other extrapyramidal disorders (inherited spinocerebellar atrophies, progressive supranuclear palsy, corticobasal degeneration, Machado-Joseph disease, FXTAS)
- Unassociated with multisystem degeneration (focal CNS disorders)
- Disorders mainly due to cerebral cortex involvement
- Frontal cortex lesions causing urinary/bowel incontinence
- Focal seizures (temporal lobe or anterior cingulate)
- Cerebral infarction of the insula
- Disorders of the limbic and paralimbic circuits
- Shapiro's syndrome (agenesis of corpus callosum, hyperhidrosis, hypothermia)
- Autonomic seizures
- Limbic encephalitis
- Disorders of the hypothalamus
- Thiamine deficiency (Wernicke-Korsakoff syndrome)
- Diencephalic syndrome
- Neuroleptic malignant syndrome
- Serotonin syndrome
- Fatal familial insomnia
- ADH syndromes (diabetes insipidus, inappropriate ADH secretion)
- Disturbances of temperature regulation (hyperthermia, hypothermia)
- Disturbances of sexual function
- Disturbances of appetite
- Disturbances of bp/HR and gastric function
- Horner's syndrome
- Disorders of the brainstem and cerebellum
- Posterior fossa tumors
- Syringobulbia and Arnold-Chiari malformation
- Disorders of bp control (hypertension, hypotension)
- Cardiac arrhythmias
- Central sleep apnea
- Baroreflex failure
- Horner's syndrome
- Vertebrobasilar and lateral medullary (Wallenberg's) syndromes
- Brainstem encephalitis
- Autonomic disorders with spinal cord involvement
- Traumatic quadriplegia
- Syringomyelia
- Subacute combined degeneration
- Multiple sclerosis and neuromyelitis optica
- Amyotrophic lateral sclerosis
- Tetanus
- Stiff-person syndrome
- Spinal cord tumors
- Autonomic neuropathies
- Acute/subacute autonomic neuropathies
- Subacute AAG
- Subacute paraneoplastic autonomic neuropathy
- Guillain-Barré syndrome
- Botulism
- Porphyria
- Drug-induced autonomic neuropathies-stimulants, drug withdrawal, vasoconstrictor, vasodilators, beta-receptor antagonists, beta-agonists
- Toxin-induced autonomic neuropathies
- Subacute cholinergic neuropathy
- Chronic peripheral autonomic neuropathies
- Distal small fiber neuropathy
- Combined sympathetic and parasympathetic failure
- Amyloid
- Diabetic autonomic neuropathy
- Autoimmune autonomic ganglionopathy (paraneoplastic and idiopathic)
- Sensory neuronopathy with autonomic failure
- Familial dysautonomia (Riley-Day syndrome)
- Diabetic, uremic, or nutritional deficiency
- Dysautonomia of old age
- Disorders of reduced orthostatic intolerance: reflex syncope, POTS, associated with prolonged bed rest, associated with space flight, chronic fatigue
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Abbreviations: AAG, autoimmune autonomic ganglionopathy; ADH, antidiuretic hormone; FXTAS, fragile X-associated tremor/ataxia syndrome; HR, heart rate; POTS, postural orthostatic tachycardia syndrome.