Isolated Failure of Autonomic Noradrenergic Neurotransmission

AUTONOMIC disorders are usually characterized by widespread abnormalities in both the sympathetic and the parasympathetic systems; this is true whether the autonomic disorder is associated with central neurologic deficits or is confined to the peripheral autonomic nervous system.1 2 3 Detailed testing can usually identify the extent of the autonomic neuronal damage,4 , 5 but it is uncommon for the abnormality to be localized to a single class of neurons. We have recently evaluated a young woman with autonomic failure in whom the pathophysiologic features of the disorder suggest an isolated failure in the β-hydroxylation of dopamine in the peripheral noradrenergic nerves.Case Report . . .