![]() In the asympathicotonic state, the heart rate response is usually impaired along with the other impairments of autonomic function. This may be perceived and reported as palpitation. An important point of differentiation between these two groups of problems is that when the autonomic response system is functioning normally (the sympathicotonic state), assumption of the upright posture is accompanied by an increase in heart rate. The terms sympathicotonic and asympathicotonic have been coined to describe situations in which the autonomic nervous system is normal (the former) and those in which a dysautonomic state exists (the latter). There are many causes in addition to primary dysautonomia for postural syncope due to orthostatic hypotension these are listed in Table 76.3. These symptoms are due to orthostatic (postural) hypotension, but the latter is a sign to be elicited on physical examination and is not, strictly speaking, part of the historical database. Note that the symptoms evident to the patient are postural dizziness, syncope, or one of the other manifestations of cerebrovascular ischemia noted in Table 76.2. ![]() It is the most commonly reported, and is usually sufficiently disturbing to be a chief complaint or presenting problem. Postural dizziness or syncope is the most striking symptom of dysautonomia. The many causes of dysautonomia are listed in Table 76.1. Finally, side effects of drugs are often manifested as abnormalities of function of the autonomic nervous system, producing an iatrogenic form of dysautonomia. There are also nonneurologic systemic illnesses of a variety of causes in which injury to the autonomic nervous system may occur and become a predominant component. The autonomic nervous system may undergo injury as part of several different degenerative neurologic diseases. It is the most dramatic of the symptoms and is the one that most often brings the patient to the physician, but it is not an adequate description of the full dysautonomic syndrome.ĭysautonomia is not a single disease process. The term orthostatic hypotension is often used as a synonym for dysautonomia. Although the latter occasionally may be involved, abnormal function of the sympathetic division produces the most striking symptoms of dysautonomic syndromes. ![]() There are two divisions of the autonomic nervous system: the sympathetic and the parasympathetic. Dysautonomia refers to an abnormality of function of the autonomic nervous system.
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