Acute total autonomic disorder

Introduction to acute total autonomic dysfunction Acute full autonomic dysfunction (acutedysautonomia) is referred to as acute autonomic neuropathy, also known as acute crisis of autonomic nervous system or sympathetic seizures, a less common disease, often acute onset. Most of the symptoms of autonomic palsy, such as abnormal pupillary reaction, less sweating, no tears, impotence, orthostatic hypotension and urinary retention, are common in young people or children. basic knowledge The proportion of illness: the incidence rate is about 0.004%-0.007% Susceptible people: more common in young people or children Mode of infection: non-infectious Complications: intestinal obstruction malnutrition

Causes of acute total autonomic dysfunction

(1) Causes of the disease

The cause is not clear, it has been found that the disease occurs after infectious mononucleosis and dysentery; some cases show an increase in antibody titer against Epstein-Barr virus, some people think that the disease is autoimmune autonomic neuropathy, similar to neurotropic virus Infection; but currently considered to be an abnormal immune response to autonomic ganglia or postganglionic nerve fibers.

(two) pathogenesis

There is currently a tendency to believe that the disease is associated with an abnormal immune response following viral infection.

Peripheral nerve autoimmune dysfunction

Cochlear nerve biopsy by domestic and foreign scholars showed that the myelin fibers and unmyelinated fibers were significantly reduced in this disease, accompanied by axonal degeneration. The lesions mainly occurred in small fibers, which was consistent with the performance of inflammatory demyelination, and some patients merged. Peripheral nerve sensation, dyskinesia, cerebrospinal fluid protein quantitative increase, normal cell number, good prognosis, it is considered that this disease is a special type of Guillain-Barre syndrome.

2. Virus infection

In recent years, it has been found that some neurotropic viruses directly invade the autonomic ganglia and post-ganglionic fibers, which may be an important mechanism leading to this disease. Besnard et al (2000) reported that a patient with intestinal obstruction as the main manifestation was detected by PCR. Epstein-Barr virus in the cerebrospinal fluid was positive, and EB virus in the muscularis of the small intestine, mesenteric lymph nodes and stomach was detected by RNA probe in situ hybridization.

Pathological changes of the disease: mainly occurs in the peripheral or central autonomic nervous system; directly affects peripheral ganglia or postganglionic sympathetic and parasympathetic functions, manifested as neuronal loss, intracranial collagen fibrosis, demyelination, axonal mutation Sexuality, sural nerve biopsy has no abnormality during the onset of the disease, but patients with autonomic dysfunction still exist after several years of onset. It can be seen that the number of unmyelinated nerve fibers is increased compared with normal, accompanied by regenerative changes.

Acute total autonomic dysfunction prevention

There is no effective prevention method for autoimmune diseases, and prevention of infection, cold, and cold or hot induced factors are the key points of prevention and treatment. Prevention and treatment of complications are also important contents of clinical medical care.

Acute total autonomic dysfunction complications Complications, intestinal obstruction, malnutrition

Very few can die due to paralytic ileus and malnutrition.

Symptoms of acute total autonomic dysfunction Common symptoms Paralysis syncope nausea dysuria and urinary retention dysfunction diarrhea constipation hypotension bloating tears, saliva and sweat...

1. The disease usually begins with acute onset, and is more common in children and adults. It is characterized by extensive or complete paralysis of autonomic nerves, such as blurred vision, abnormal pupillary response to light and regulation, large pupil size, and reduced secretion of tears, saliva and sweat. Or disappear, as well as urinary retention, impotence, gastrointestinal dysfunction (nausea, vomiting, constipation, bloating or diarrhea) and abnormal body temperature regulation.

2. Can cause syncope due to orthostatic hypotension, but at this time the heart rate is normal, a small number of patients may be accompanied by peripheral nerve movement and sensory disturbance.

Examination of acute total autonomic dysfunction

Cerebrospinal fluid routine examination showed increased protein.

1. X-ray examination has gastrointestinal muscle tension relaxation.

2. The sweating reaction of pilocarpine subcutaneous injection test is often weakened.

3. The use of 2.5% methacholine (acetylcholine) eye drops often cause pupil dilation, while intradermal injection of histamine is normal.

Diagnosis and diagnosis of acute total autonomic dysfunction

The diagnosis of this disease is mainly based on the clinical manifestations of acute majority of autonomic dysfunction symptoms.

It should be differentiated from Guillain-Barre syndrome, diabetes, or alcoholic neuropathy, familial autonomic dysfunction.

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