Key result
The evaluation and management of autonomic neuropathies require an individualized approach combining disease-modifying therapies, symptomatic pharmacologic therapies, and nonpharmacological management.
Why the study?
To provide a practical approach to the evaluation and management of patients with autonomic neuropathies.
The evaluation and management of autonomic neuropathies should be individualized, utilizing a combination of disease-modifying, symptomatic, and nonpharmacological therapies.
Emphasizes careful history-taking to guide testing in complex autonomic neuropathies; leaves open.
PURPOSE OF REVIEW: The review focuses on the practical evaluation and management of patients with autonomic neuropathies. RECENT FINDINGS: Autonomic neuropathies are complex disorders and result in diverse clinical manifestations that affect the cardiovascular, gastrointestinal, urogenital, and sudomotor systems. The autonomic medical history is key when seeing a patient with suspected autonomic neuropathy. The history guides the clinical evaluation, laboratory testing, and autonomic testing in patients with autonomic neuropathies. The treatment of autonomic neuropathies is based on the combination of disease-modifying therapies, symptomatic pharmacologic therapies, and nonpharmacological management. Response to treatment can be assessed with quantitative autonomic biomarkers. SUMMARY: Treatment of autonomic neuropathies should be individualized, guided by disease state, medications' mechanism of action and adverse event profile as well as cost. Genetic discoveries and pathologic understanding lead to the development of disease-modifying therapies as seen in familial amyloid polyneuropathy.
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Lamotte et al. (2021) conducted a review in Peripheral autonomic neuropathies. The evaluation and management of autonomic neuropathies require an individualized approach combining disease-modifying therapies, symptomatic pharmacologic therapies, and nonpharmacological management.
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