You might be asking yourself, “What is Dysautonomia? What do the symptoms look like? Could I have it?” Here at Carolina Functional Neurology Center, we treat several types of Dysautonomia. While there are many similarities across all forms of Dysautonomia, it is important to understand the differences between each form and identify exactly what type you are suffering from so that we can develop a personalized treatment plan that targets your body’s specific needs.
Dysautonomia is an umbrella term that means you aren’t regulating your autonomic nervous system properly. Your autonomic nervous system is responsible for regulating involuntary physiological processes such as heart rate, blood pressure, respiration and digestion. Symptoms can vary for each individual and fall along a wide spectrum, based on the type of Dysautonomia you have. There are many types of Dysautonomia, however below are some of the more common types.
Postural Orthostatic Tachycardia Syndrome (POTS)
One of the most well-known forms of Dysautonomia is Postural Orthostatic Tachycardia Syndrome (POTS). POTS can be diagnosed when someone has a normal or lower resting heart rate, but when they move against gravity they experience a change in heart rate of 30 points for adults and 40 points for children.
With POTS, we find neurological dysfunction often resides in the pontomedullary areas of the brainstem. This area is responsible for eye movements, motor and sensory control to the face, sound conduction, swallowing, taste and coordination to the tongue and throat, and motor control of some neck muscles.
Subcategories of POTS include:
Neuropathic POTS, which is when small fiber nerves are damaged
Hypovolemic POTS, which is associated with abnormally low levels of blood
Hyperadrenergic POTS, which deals with elevated levels of norepinephrine, a stress hormone
Immune-Mediated POTS, which attacks elements of the immune system so the treatment would require immune-boosting strategies in addition to other strategies to address typical POTS symptoms
Because the autonomic nervous system controls almost every system in our body, subtypes of POTS can manifest differently for each individual. It is important to understand which subtype you have because this can alter symptoms and some symptom management strategies.
Inappropriate Sinus Tachycardia (IST)
A similar condition to POTS is Inappropriate Sinus Tachycardia (IST). The biggest difference is that IST is diagnosed when a patient’s resting heart rate is over 100 beats per minute (bpm) with an average 24-hour heart rate over 90 bpm. IST is associated with symptoms such as palpitations, dyspnea or dizziness. In the cases of IST, it is often seen that the dysfunction in the brain is concentrated in the mesencephalon or midbrain. This area of your brainstem is responsible for many functions including pain modulation, consciousness, sleep rhythms, pupillary responses, eye movements, DOPAminergic and GABAergic centers. Your midbrain is in constant communication with your limbic centers, cortex, sympathetic ganglion and more.
Orthostatic Hypotension occurs when someone experiences a rapid drop in blood pressure (40 points or more) when they stand. Someone who experiences a rapid drop in blood pressure but by less than 40 points can be diagnosed with Orthostatic Intolerance. Orthostatic Hypotension is more commonly seen in the elderly and often time comes along with other neurological conditions.
Syncope is defined as a loss of consciousness for a short period of time. People who suffer from POTS, IST and Orthostatic Hypotension can experience syncope, but it doesn’t always come with those conditions. There are several types of syncope that can be diagnosed based on what is causing an individual to lose consciousness. A tilt-table test can show fluctuation in vitals and can help diagnose the specific type of syncope someone is experiencing.
Pre-Syncope - This is when an individual feels like they are going to pass out, however their brain has developed the compensatory mechanisms to prevent passing out. They do not actually lose consciousness, but they do experience symptoms of Dysautonomia.
Vasovagal Syncope (VVS) - Also known as Neurocardiogenic Syncope, occurs when someone experiences a drop in heart rate and blood pressure causing them to pass out.
Cardioinhibitory Syncope (CS) - This is a neurally mediated response that can cause bradycardia, a slower than normal heart rate, or asystole, which is when the heart no longer has electrical and mechanical activity.
Vasodepressor Syncope - This occurs when an individual loses consciousness due to a drop in blood pressure.
Oftentimes a solution for these conditions is steroids. However, steroids can cause side effects and other potential issues for the body. Working with a functional neurologist who is familiar with the intricacies of your nervous system can be helpful for proper rehabilitation in the nervous system.
At Carolina Functional Neurology Center, we can work with you to pin-point where the dysfunction is in the brain, and develop a custom plan to get you the most effective results. Dysautonomia conditions can make you feel debilitated, but we can help you feel like yourself again! Click here for more information on our Dysautonomia Program.