Massage & Bodywork

JANUARY | FEBRUARY 2020

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Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 37 alive. These motor signals are discussed as sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) responses. WHAT IS DYSAUTONOMIA? Dysautonomia occurs when a problem in ANS neurons affects the ways we respond to the environment. This can manifest as suppressed or exaggerated reactions in sympathetic or parasympathetic responses, such as a racing heartbeat, a slowdown in digestive motility, or an inability to sweat. In this way, the term dysautonomia doesn't apply to any specific problem or pathology. Instead, it is an umbrella term that describes the results of disruptions in normal autonomic function. Many conditions can be considered types of dysautonomia, and experts have classified them in several ways. Dysautonomia can be local or generalized; it can be acute and reversible or progressive and chronic; and it can be a primary freestanding problem or secondary to some other disease. COMMON TYPES OF DYSAUTONOMIA The main focus of this article is POTS. However, many other types of dysautonomia have been identified, and brief descriptions of some of them follow. Neurocardiogenic syncope. This common condition involves unpredictable fainting spells. While it is often mild, it can cause falls and risks for serious injury. Pure autonomic failure. This describes orthostatic hypotension along with many other autonomic challenges, including digestive problems, urinary retention, decreased sweating and heat intolerance, and sexual dysfunction. Autoimmune autonomic neuropathy. This is an immune system attack on acetylcholine receptors. It can involve sensory problems along with motor disturbances. Multiple system atrophy (MSA). Unlike other forms of dysautonomia, MSA affects brain function as well as peripheral nervous system function. This progressive condition has aspects of Parkinson's disease and ataxia (lack of voluntary coordination). MSA usually affects mature people, and it is progressive and terminal. Other types. Dysautonomia can be a result of long-term toxic exposures, alcoholism, untreated diabetes, and peripheral nerve trauma that leads to complex regional pain syndrome. Autonomic dysreflexia (a dangerous syndrome seen in people with spinal cord injuries), cerebral salt wasting syndrome, and familial dysautonomia are other examples of autonomic system failures. Watch "The Lowdown on Lightheadedness, Dysautonomia, and POTS" There is no cure for POTS or other types of autonomic dystonia. Treatment is aimed at managing symptoms, through several types of interventions. WHAT IS POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME? Postural orthopedic tachycardia syndrome (POTS) refers to a group of signs and symptoms that include increased heart rate (tachy [fast] + cardia [heart]) in an upright position (ortho [upright] + stasis [state of being]). It is a type of dysautonomia that mainly affects the ability to maintain stable blood pressure, but its impact on many body functions can make it an extremely challenging condition to live with. It is hard to estimate how many people are affected by POTS. Some experts suggest that somewhere between 1 and 3 million Americans have some kind of dysautonomia, and POTS is one of the most common versions. It is usually diagnosed in women (80–85 percent of patients are women of child-bearing age). While some patients find their symptoms diminish over time, many have it as a lifelong condition. And about 25 percent of patients with POTS have it severely enough that it interferes with their ability to work, drive, or participate in normal daily activities. POTS PATHOPHYSIOLOGY What exactly goes wrong in the ANS to cause POTS is not well understood. Researchers believe it may have an autoimmune component, because it is often seen alongside several autoimmune conditions, including Sjogren's syndrome, lupus, myasthenia gravis, and multiple sclerosis. It also affects a population— women of childbearing age—that is affected by autoimmune conditions more often than other groups.

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