Neurovegetative dysautonomia: when the nervous system does not function as it should

Neurovegetative dysautonomia: what is it? The nervous system is divided into a central nervous system and a peripheral nervous system

The central nervous system, which is located in the skull and spinal canal, comprises the brain, cerebellum, brainstem and spinal cord.

The peripheral nervous system is made up of the cranial nerves (which innervate the head and neck), the spinal nerves (which innervate the remaining parts of the body) and the ganglia (special groups of neurons that receive information from receptors).

The peripheral nervous system is further subdivided into voluntary, which is responsible for controlling voluntary movements and collecting information from the sense organs, and involuntary or autonomic (or vegetative or visceral or autonomic), which controls involuntary bodily functions.

Finally, the autonomic nervous system is divided into two opposing parts: sympathetic (originating in the spinal cord) and parasympathetic (originating in the brainstem and spinal cord).

The autonomic nervous system can malfunction, in which case we speak of neurovegetative dysautonomia or autonomic dysfunction

What is it or how does it manifest itself?

The functions of the autonomic nervous system

The autonomic nervous system regulates the activity of glands and internal organs such as the heart, stomach and intestines, controlling functions such as dilating pupils, saliva and mucus production, heart rate, blood pressure, contraction of bronchial muscles, stomach and intestinal movements, urine production, relaxation of the bladder wall and opening of the bladder sphincter.

The sympathetic nervous system is particularly active when the body experiences emergency or stress situations such as attack and escape responses, while the parasympathetic is prevalent in stable and resting conditions and supports processes such as digestion and absorption, growth and energy storage.

When is neurovegetative dysautonomia?

In the presence of a malfunction of the autonomic nervous system we have neurovegetative dysautonomia (or autonomic dysfunction).

The disorders that can occur are diverse, examples include:

  • impaired regulation of blood pressure and heart rate with orthostatic hypotension and hypertension in clinostatism (lying down);
  • disorders of respiratory function;
  • gastrointestinal disorders with reduced gastrointestinal motility, dysphagia, constipation, diarrhoea;
    sexual and urinary disorders with nocturia, pollakiuria, urge to urinate, impotence, loss of sphincter control;
  • thermoregulation disorders;
  • hypo-anhidrosis;
  • sleep disturbances.

Orthostatic hypotension is the most disabling disorder; it is characterised by a reduction of at least 20 mmHg in systolic blood pressure or 10 mmHg in diastolic blood pressure within three minutes of standing and is manifested by light-headedness, fatigue, fatigue, blurred vision and syncope.

Neurovegetative dysautonomia: classification of autonomic nervous system diseases

This classification is very complex. In general, a distinction is made between focal and generalised dysautonomias.

Focal dysautonomias are characterised by sectoral symptoms; examples are Bernard Horner’s syndrome with ptosis (drooping of the eyelid), miosis (narrowing of the pupil) and facial anhidrosis (no sweating on the face) and Adie’s syndrome with the pupil not reacting to light and the abolition of osteotendinous reflexes).

Generalised dysautonomias, on the other hand, are divided into central (brain or spinal cord) and peripheral (nerves).

Central ones include:

  • pure autonomic failure
  • autonomic failure during multisystem atrophy, which combines failure of the autonomic nervous system with neurodegeneration of the central nervous system;
  • autonomic failure associated with Parkinson’s disease.

Finally, peripheral dysautonomias are divided into acute (Guillain Barrè syndrome, botulism, porphyria, toxic disorders) and chronic (hereditary neuropathies, diabetic neuropathies, toxic-carcinogenic, infectious and paraneoplastic neuropathies).

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