Autonomic crisis

Introduction Acute dysautonomia (acute dysautonomia) is called acute autonomic autonomic disease, also known as acute crisis of autonomic nervous system or sympathetic seizures, a rare disease. The disease usually begins with acute onset, and is more common in children and adults. It is characterized by extensive or incomplete paralysis of the autonomic nerves, such as blurred vision, abnormal pupillary response to light and regulation, large pupils, and reduced or disappeared secretion of tears, saliva and sweat. , as well as urinary retention, impotence, gastrointestinal dysfunction (nausea, vomiting, constipation, bloating or diarrhea) and abnormal body temperature regulation.

Cause

The disease occurs after infectious mononucleosis and dysentery; in some cases, the antibody titer of Epstein-Barr virus is increased. Some people think that this disease is autoimmune autonomic neuropathy similar to neurotropic virus infection; but it is currently considered to be an abnormal immune response to autonomic ganglia or postganglionic nerve fiber health search.

Traditional Chinese medicine believes that this disease should belong to the category of stagnation syndrome. This disease has many emotional factors, and the general syndrome is liver qi stagnation. The doctors of the past generations have a lot of records on this disease, such as Ming? Xu Chunxi, "Ancient and Modern Medicine. Yuzhengmen": "Yu is a seven-love uncomfortable, and it becomes a stagnation of stagnation. It is not only a long time, but also a disease." It is characterized by emotional illness and diverse clinical symptoms. Zhu Danxi's "Danxi Xinfa. Liuyu" has listed the stagnation of stagnation as a special article and pointed out that "the qi and blood are rushing, and the ailments are not born, and there is a stagnation of stagnation, and all diseases are sputum. ", qi and blood stasis can change the card for a long time, such as qi stagnation, fire, yin, liver yin deficiency, liver and kidney homologous, long-term syndrome of liver and kidney yin deficiency; worrying and sorrowful, causing heart yin Insufficient, heart-wrenching, water and fire are inferior; liver qi stagnation, liver and wood spleen, spleen lost health, long-term spleen and kidney deficiency. Therefore, the teacher believes that the refractory autonomic dysfunction is mostly a syndrome of deficiency and reality, and is related to liver, kidney, heart and spleen.

an examination

Related inspection

Cerebrospinal fluid weight cranial nerve examination

Symptoms and signs:

1. The disease is usually acute onset, more common in children and adults, manifested as extensive or complete paralysis of autonomic nerves, such as blurred vision, pupillary light and regulation response abnormalities, pupils are not large, tear, saliva and sweat secretion decreased Or disappear, as well as urinary retention, impotence, gastrointestinal dysfunction (nausea, vomiting, constipation, bloating or diarrhea) and abnormal body temperature regulation.

2. It can cause syncope due to orthostatic hypotension, but the heart rate is normal at this time. A small number of patients may be accompanied by peripheral nerve movements and sensory disturbances.

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

Laboratory examination: increased cerebrospinal fluid examination showed increased protein.

Differential diagnosis

Differential diagnosis of autonomic crisis:

1, Guillain-Barre syndrome: also known as acute infectious polyneuritis; acute polyneuritis; acute ascending paralysis; Landry paralysis.

2, diabetes: Diabetes (diabetes) is caused by genetic factors, immune dysfunction, microbial infection and its toxins, free radical toxins, mental factors and other pathogenic factors in the body leading to islet dysfunction, insulin resistance (Insulin Resistance, IR), a series of metabolic disorders such as sugar, protein, fat, water and electrolytes, clinically characterized by hyperglycemia, typical cases can appear polyuria, polydipsia, polyphagia, weight loss, etc. "Three more than one less" symptoms.

3, alcoholic neuropathy: refers to the mental disorder caused by alcohol.

4, familial autonomic dysfunction: familial autonomic dysfunction is familial autonomic dysfunction syndrome. It is a natural disease characterized by neurological dysfunction, especially autonomic dysfunction. The cause is unknown and is autosomal recessive. Its onset may be related to abnormal metabolism of catecholamines in the body. The clinical manifestations are as follows:

1 lack of tears: no tears or tears when crying;

2 sweating more: regular movement is a lot of sweat, but the sweat composition is normal;

3 blood pressure is unstable: often suddenly rises or falls;

4 When eating or agitation, symmetrical red spots on the shoulders, neck, chest and face often appear, and then fade away later;

5 abnormal body temperature regulation, often have unexplained fever, often with high fever;

6 digestive tract symptoms: periodic nausea and vomiting, abdominal pain, etc., some have difficulty swallowing and food reflux;

7 neuropsychiatric symptoms: late speech, dysarthria, emotional instability, low intelligence, clumsy movements, ataxia, etc.;

8 The body is short and thin and slow to develop.

Symptoms and signs:

1. The disease is usually acute onset, more common in children and adults, manifested as extensive or complete paralysis of autonomic nerves, such as blurred vision, pupillary light and regulation response abnormalities, pupils are not large, tear, saliva and sweat secretion decreased Or disappear, as well as urinary retention, impotence, gastrointestinal dysfunction (nausea, vomiting, constipation, bloating or diarrhea) and abnormal body temperature regulation.

2. It can cause syncope due to orthostatic hypotension, but the heart rate is normal at this time. A small number of patients may be accompanied by peripheral nerve movements and sensory disturbances.

Diagnosis: The diagnosis of this disease is mainly based on the clinical manifestations of acute majority autonomic dysfunction. Laboratory examination: increased cerebrospinal fluid examination showed increased protein.

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