Autonomic neuropathy
 

This is my first post on behalf of my husband. He has had idiopathic peripheral neuropathy for about 8 years - he is 62. It started in his feet and has progressed to his lower legs and hands to some degree.

He recently passed out and was diagnosed with ventricular tachycardia.

However he as many other symptoms, which have also developed fairly recently, and I am now beginning to wonder if his neuropathy has become autonomic. Difficulty urinating, excessive sweating, shortness of breath, face pallor, face flushing, extreme fatigue, nausea/heartburn.

We have mentioned all this to his GP, who is normally very good, but he said a lot of these symptoms can be put down to his meds - Gabapentin, amitriptylene, morphine and now beta blockers.

Does anyone have any experience with autonomic neuropathy? Is this a likely progression from the peripherial neuropathy?

I haven't expressed my "fears" to my husband yet, but would be interested in any thoughts?

Thanks, Linda

I am truly sorry about your husband.
I hope this link will help you get some information about Autonomic Neuropathy.

http://www.patient.co.uk/doctor/Auto...Neuropathy.htm

Welcome to NeuroTalk:

It is true that some side effects you describe are common with the drugs. A person who has shortness of breath, should not be on beta blockers. This can result in a bronchospasm, which can be life threatening. What is your husband taking a beta blocker for? Fatigue also from beta blockers and morphine, and gabapentin. Beta blockers typically reduce aerobic capacity, such as running or climbing stairs.
Sweating can come from the morphine.

Amitriptyline is not indicated in patients with heart rhythm problems. What dose is he on? It can also cause urinary retention.

So the problem exists, and each drug needs to be looked at carefully and in combination with the others.

Here is a good drug checker:
http://www.drugs.com/drug_interactions.html

Sometimes one has to be emphatic with doctors when quality of life gets too low. Unless you are very vocal...they tend to ignore your discomforts.

Thank you for the replies. He is on beta blockers for the tachycardia - they regular his heart rate and blood pressure. He is also anemic, which obviously causes tiredness too - no known cause for that yet.

The hospital were aware of what drugs he takes when they put him on the beta blockers, and his shortness of breath. That isn't extreme, but is there on occasion.

So it's almost a damned if you do, damned if you don't scenario. I think too it appears to be a process of elimination - keep testing to rule out certain things. He is also going for a sleep apnea test.

I have to say that we have been lucky with his physicians and their treatment of him.

Good luck to everyone suffering from this horrible ailment.

I have Autonomic Neuropathy (POTS=Postural Orthostatic Tachycardia Syndrome), a form of Dysautonmia. I do not take meds so I do not know the side effects.

I have been taking Benicar for the rise in blood pressure but I am almost off of that now thankfully. I only take supplements for healing the nerves.

I have severe dysautonomia (or autonomic neuropathy) secondary to Sjogren's. I take multiple meds and have a pacemaker.

I can tell you that morphine (any narcotic really) can, and will, make autonomic symptoms worse...like the difficulty urinating, delayed stomach emptying, etc. But I also understand the need for pain mgmt. Although my dysautonomia started long before I got considerable pain from PN, I now have no choice but the treat the pain. Luckily only a few minor adjustments in meds were necessary. It is possible to manage both, but will take a little patience...and some persistence with the doctors.

Has he been worked up for POTS with tilt table test? With the added autonomic problems on top of PN, it might not be a bad idea to start exploring the cause of the PN...and now AN. This should include autoimmune testing, B12, and of course diabetes (GTT). What may have been explored 8 years ago (and nothing found) might now be ready to present itself, so some tests should be repeated.

Thank you again both of you for your replies. It would seem then it's a matter of exploring everything - he hasn't actually been diagnosed with AN yet, this is just my thinking. It's early stages for the V-Tach - the tilt table and Valsava test are out of the question at the moment because of that.

He has recently been given a work over for the obvious diabetes, B12, folate, autoimmune etc. and nothing shows. It never has, so it's always been idiopathic.

I suspect it's some kind of genetic dispostion - his father had both legs removed below the knew when he was in his fifties, for what was then called ciruculatory problems. He got an infection in both feet that turned gangranous(spelling?), and my husbands grandfather apparently always had painful feet which was called gout!

Linda

[QUOTE=en bloc;879899]I have severe dysautonomia (or autonomic neuropathy) secondary to Sjogren's. I take multiple meds and have a pacemaker.

I can tell you that morphine (any narcotic really) can, and will, make autonomic symptoms worse...like the difficulty urinating, delayed stomach emptying, etc. QUOTE]

Hi en bloc,

Lately, I have been experiencing abdominal bloating. This happens after eating. Today I tried eating a little during lunch because its after my lunch that I feel bloated the most. The bloating was not as bad as when I have my normal intake.

I have been reading about gastroparesis... it says that symptoms are slow emptying (bloating), vomitting, nausea, loss of appetite, etc. Among the symptoms, I have only the bloating.

My questions are:

1. How is gastroparesis diagnosed?
2. When you have gastroparesis, does it mean that you have Autonomic Neuropathy?
3. Should the typical symptoms of gastroparesis be all present to be considered as such?

Thank you.

1) Gastroparesis is diagnosed with an GI empty study. Basically you eat some scrambled eggs that have a little contrast mixed in and you lay down for 2 hours while the nuclear xray takes images (like every 90 seconds), tracking the food and determining the empty time.

2) gastroparesis IS an autonomic dysfunction

3) most with gastroparesis have more then just bloating. early satiety (fullness) is most common, along with nausea/discomfort after eating.

Hope this is helpful. You should see a GI doctor if your bloating does not resolve...it could many different things.

Thank you en bloc!

On Question No. 2, I know gastroparesis is an Autonomic Neuropathy (why did I ask that question, duh!;). What I meant to ask was, if one has gastroparesis, does it follow that one will have the other symptoms of autonomic neuropathy e.g. orthostatic hypotension, urinary problem, lung problem,etc.?

Another thing, if I have a SFN, is it common or is it likey that I will also have autonomic neuropathy?

I remember, though, several years ago, I had an annual physical exam and I had this test which I was made to drink what seems to be "milkish" in form and I lied down while the technician monitor the flow of that white milkish drink. I could vaguely remember that it took a while before the white milkish settled down. But, at that time, I was perfectly fine. The reason I had that test was because it was part of an annual physical exam package.

I dont feel nauseated nor have the urge to vomit after eating. But, I definitely feel full after eating even with small amount of food.

Also, the reason why I asked about other symptoms is because my shortness of breath (which accompanies the tightness in my front neck) has been persistent. It is not a shortness of breath that is like gasping for air. In fact, I do stationary bicycle 5x a day and do a short walk. I dont think that my s hortness of breath is due to asthma. I dont have wheezing and cough or any related asthma symptoms.

I am fearful that the shortness of breath may be another symptoms of another damaged nerve. I really really hope not..... I am seeing a pulmonologist in July.