Evaluation and Management of Autonomic Disorders. A Case-Based Practical Guide

PART A. GENERAL PRINCIPLES 1. Anatomy, physiology and pharmacology of the Autonomic nervous system 2. Classification of Autonomic disorders a. autonomic failure b. autonomic hyperactivity c. orthostatic intolerance 3. General evaluation of autonomic disorders a. History and examination b. Syndrome specific evaluation 4. Principles of managements of autonomic disorders a. Orthostatic hypotension b. Gastrointestinal and genitourinary manifestations c. Autonomic hyperactivity PART B. CLINICAL CASES Scenario 1. Acute or subacute Pure autonomic failure Case 1.1. Autoimmune Autonomic ganglionopathy. Differential diagnosis: paraneoneoplastic disorders Scenario 2. Chronic and progressive Pure autonomic failure Case 2.1. Pure Autonomic Failure (PAF) Scenario 3. Chronic autonomic failure associated with Parkinsonism, ataxia or dementia Case 3.1. Parkinson's disease (PD). Differential diagnosis: Lewy body Dementia Case 3.2. Multiple System Atrophy (MSA). Differential diagnosis: MSA sub type Parkinsonism versus PD Scenario 4. Autonomic failure in chronic peripheral neuropathy Case 4.1. Diabetes Mellitus - Diabetic autonomic dysfunction in different organs Case 4.2. Amyloidosis - Amyloidotic autonomic neuropathies Scenario 5. Autonomic failure in subacute sensory ganglioneuronopathies Case 5.1. Sjoegren's Syndrome. Differential diagnosis: paraneoplastic disorders Scenario 6. Autonomic failure and acute motor weakness Case 6.1. GBS. Differential Diagnosis: Botulism, Porphyria, Lambert Eaton Syndrome Scenario 7. Distal painful autonomic neuropathy Case 7.1. Small fiber neuropathy. Differential diagnosis: HIV, Fabry Disease, Alcohol Scenario 8. Orthostatic intolerance Case 8.1. Vasovagal Syncope. Differential diagnosis: other reflex syncope, cardiac syncope, carotid sinus Case 8.2. Postural Orthostatic Tachycardia Syndrome (POTS) Scenario 9. Autonomic hyperactivity Case 9.1. Severe brain injury

This book approaches the basic features of autonomic dysfunction in a practical way, complemented by an examination of unique and didactic case reports. Unlike other books on autonomic disorders, its goal is to provide a brief, practical and ready to use resource for physicians faced with patients' autonomic complaints. Autonomic dysfunctions are specific disorders that affect or are related to the autonomic nervous system. Despite being primarily a field of neurology, it also has important ties to cardiology, endocrinology, gastroenterology and many other medical specialties. Moreover, as the action of the autonomous system tends to be diffuse, affecting different systems and organs throughout the body, its disorders may present a complex and multifaceted background, complicating its diagnosis, clinical evaluation and management. Thus, it is important to gather all the relevant information about autonomic dysfunction in a handy and practical way, providing an accessible guide for professionals and practitioners across a wide range of specialties. The content presented in this book is divided into two main parts: In the first part, the general principles of autonomic dysfunction are discussed. Here the reader will find information on the anatomy, physiology and pharmacology of the nervous system, the classification of autonomic disorders, general evaluation of these disorders and the principles of their management. In the second part, clinical cases for the most important autonomic disorders are presented and discussed in detail, particularly in light of their special importance for differential diagnosis. Using a clinical case-based approach, Evaluation and Management of Autonomic Disorders offers readers - primarily but not exclusively general practitioners in the fields of neurology, internal medicine, family medicine and cardiology - rapid access to the information required for the evaluation and management of these complex patients.

Juan Idiaquez: Professor Idiaquez works at the Universidad de Valparaiso and Pontificia Universidad Catolica de Chile. His research to date has chiefly focused on clinical and neurophysiological studies of autonomic dysfunction in central and peripheral nervous system disorders and the influence of the aging process on autonomic function in healthy subjects. He has contributed substantial work on the quantitative assessment of symptoms and noninvasive autonomic tests in these areas, and has published in close collaboration with experts from major clinical autonomic departments.

Eduardo Benarroch: Professor Benarroch is a Consultant to the Department of Neurology at the Mayo Clinic in Rochester, Minnesota. His research has mainly focused on the neuropathological basis of autonomic failure in neurodegenerative disorders, and he has published extensively in this and other areas related to autonomic function and diseases. He is co-author with Professor Phillip Low of the book Clinical Autonomic Disorders.

Martin Nogues: Professor of Neurology at the University of Buenos Aires and Chairman of the Neurology Department and Neurophysiology Lab at FLENI. His activities have included coordinating the Department and the neuromuscular unit, teaching neurology to students and residents, and conducting clinical research on neuromuscular diseases and autonomic dysfunction. Dr. Nogues is an active member of the Argentine Neurological Society and the Argentine Neurophysiological Society, as well as a member of the editorial committee of the Journal of Clinical Autonomic Research. He is also a past member of the Royal Society of Medicine and of the American Association of Electrodiagnostic Medicine