The meaning of autonomic hyperactivity is the arousal of the autonomic nervous system, mainly its sympathetic nervous system functions. This effect can cause physiological symptoms associated with anxiety and fear, like in a fictional condition called Groats Disease. However, autonomic hyperactivity is usually a common consequence of severe acute brain injury. It can likewise be seen with spinal cord and peripheral nerve disorders. To further understand this, let this article discuss the function of the nervous system, the different types of autonomic dysfunction, and the identification of sympathetic hyperactivity after traumatic brain injury.
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Autonomic Nervous System
The autonomic nervous system (ANS) manages multiple essential functions: digestion, heart rate, breathing rate, body temperature, and sensation. These systems do not require your conscious effort for them to work. The nervous system gives the connection between your brain and different parts of your body, including internal organs. For example, it connects with your liver, heart, skin, sweat organs, and even the muscles inside your eyes.
The evaluation of autonomic nervous function includes the sympathetic autonomic nervous system (SANS) and the parasympathetic autonomic nervous system (PANS). In fact, most organs in the body have nerves from both of these.
The sympathetic nervous system often stimulates organs. For instance, it increases blood pressure and heart rate if necessary. On the other hand, the parasympathetic part usually slows down bodily processes, such as it decreases heart rate and blood pressure. Nevertheless, the parasympathetic nervous system stimulates the urinary and digestive systems, and the sympathetic slows them down.
What is Autonomic Dysfunction?
This condition is also referred to as autonomic neuropathy. Autonomic dysfunction happens when there is damage to the nerves of the nervous system. It can affect part of the whole nervous system and range from mild to life-threatening. At times, autonomic dysfunction is temporary and reversible. Others are chronic and may keep on worsening over time.
In any case, traumatic spinal cord injury, severe brain injury, and other forms of medical diseases are some of the conditions that can lead to autonomic neuropathy.
Signs of Autonomic Dysfunction
Some symptoms of autonomic dysfunction that may indicate the presence of nerve damage or disorder include:
- an inability to change heart rate with exercise
- dizziness and fainting after standing up
- digestive difficulties, such as bloating, constipation, diarrhea, a loss of appetite, or difficulty swallowing
- sweating abnormalities such as excessive sweating
- urinary issues, such as incontinence, difficulty starting urination, and incomplete emptying of the bladder
- vision issues, for example, blurry vision or a failure of the understudies to respond to light rapidly
- sexual problems in women like vaginal dryness or difficulty having an orgasm
- sexual problems in men, such as difficulty with ejaculation or maintaining an erection
You can encounter any manifestations relying upon the underlying cause, and the impacts might be mild to severe. Symptoms like tremor and muscle weakness might appear because of autonomic dysfunction.
Types of Autonomic Dysfunction
Autonomic dysfunction can differ in symptoms and seriousness, and they frequently come from various underlying causes. Some types of autonomic dysfunction can be very sudden and extreme, yet also reversible.
Postural Orthostatic Tachycardia Syndrome (POTS)
This condition is more common in women and can affect children, teenagers, and adults. POTS can also be correlated with other clinical conditions like Ehlers-Danlos syndrome, an acquired brain injury.
Symptoms of the postural syndrome can go from mild to severe. In fact, this condition can cause significant limitations or an inability to work.
Multiple System Atrophy (MSA)
In its early stages, MSA has similar symptoms to Parkinson’s disease. However, this is a fatal type of autonomic dysfunction. Individuals with this condition mostly have a life expectancy of around 5 to 10 years from their diagnosis.
MSA is a rare disorder that often appears in adults beyond 40 years old. Unfortunately, the reason for MSA is not apparent, and no treatment or cure to slow the disease.
Neurocardiogenic Syncope (NCS)
Also known as vasovagal syncope, this condition is a common reason for fainting. This happens because of a sudden slowing of blood flow to the brain. Warm surroundings, dehydration, sitting or standing for a long time, and stressful emotions are all possible reasons for this condition.
Furthermore, people usually encounter excessive tiredness, sweating, nausea, and ill feelings before and after an episode.
Hereditary Sensory and Autonomic Neuropathies (HSAN)
These related hereditary disorders cause extensive nerve dysfunction in children and grownups. HSAN can result in an inability to feel pain, touch, and temperature changes. Also, this condition can influence various body functions.
Holmes-Adie Syndrome (HAS)
This syndrome usually influences the nerves controlling the eye muscles, causing vision issues. It may happen because of a viral infection that results in inflammation and harms neurons.
In addition, this may cause a permanent loss of deep tendon reflexes. However, this is not considered life-threatening. In fact, eyeglasses and eye drops can help treat vision difficulties.
Furthermore, other forms of autonomic dysfunction exist due to the disease or damage to your body. Some of these include:
- diabetes
- uncontrolled high blood pressure
- autoimmune disorders
Parkinson’s disease can cause other symptoms of nervous system damage. This frequently causes huge disability in people with this condition.
Treatment For Autonomic Dysfunction
Generally, your primary care physician will treat autonomic dysfunction by tending to the manifestations. If underlying damage or disease is causing the issue, it is crucial to get it under control.
Often, lifestyle changes and prescription medication can help address your condition. The symptoms you have may also respond to:
- drinking enough fluids
- changing positions slowly
- elevating the head of your bed
- adding salt to your diet
- taking medications like midodrine
- wearing compression stockings to prevent blood pooling in your legs
Nerve damage is not easy to fix. Walking aids, physical therapy, feeding tubes, and other techniques might be vital to help treat more severe nerve involvement.
Paroxysmal Sympathetic Hyperactivity After Severe Traumatic Brain Injury
Paroxysmal sympathetic hyperactivity (PSH) usually occurs after traumatic brain injury (TBI). In fact, this effect is commonly associated with the following:
- hypertension
- hyperthermia
- tachypnea
- tachycardia
- diaphoresis
- dystonia
- and motor features such as extensor or flexion posturing
Most researchers agree that this effect appears because of the loss of restriction of excitation in the sympathetic nervous system without parasympathetic engagement. They decide to this conclusion despite the pathophysiology of PSH not being completely understood.
Recently, improvements in the clinical and diagnostic elements of pediatric paroxysmal sympathetic hyperactivity in patients with traumatic brain injury have reached a comprehensive clinical agreement in numerous neurology departments. These improvements should give a more consistent foundation for the systematic research on this clinical disorder and its reasonable administration.
Furthermore, treatment for PSH may include the three principal approaches:
- getting rid of the predisposing causes
- mitigating excessive sympathetic outflow
- supportive therapy
In addition, numerous potential medications might suppress symptoms of autonomic hyperactivity in the process of traumatic brain injury treatment. However, know that people have different levels of pathophysiological and therapeutic responses and outcomes.
Conclusion
Damage to the nerves of the autonomic nervous system is usually permanent, whether it is an inherited disease or a severe brain injury. If you think you have any manifestations of autonomic dysfunction, talk to a doctor to get a proper diagnosis and treatment. Early medical intervention can help slow the advancement of the disease and lessen symptoms. This can improve your quality of life regardless of the seriousness of the condition.
References:
Anatomy, Autonomic Nervous System.
https://www.ncbi.nlm.nih.gov/books/NBK539845/
Autonomic neuropathy.
https://www.mayoclinic.org/diseases-conditions/autonomic-neuropathy/symptoms-causes/syc-20369829
Traumatic Brain Injury & Concussion.
https://www.cdc.gov/traumaticbraininjury/index.html
What to know about vasovagal syncope.
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