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education PATHOLOGY PERSPECTIVES The Lowdown on Lightheadedness Dysautonomia and POTS By Ruth Werner Try this experiment: Settle into a comfortable chair and relax for a few moments. Breathe deeply. Invite a calming, parasympathetic state to take control for a bit. And now, stand up—fast! Hopefully, you didn't get dizzy and fall over, because your autonomic nervous system (ANS) functions to keep you stable, even during rapid changes in position. But what happens when parts of the ANS fail? That is basically what happens with postural orthostatic tachycardia syndrome (POTS), a type of dysautonomia. AUTONOMIC NERVOUS SYSTEM REVIEW Because this article deals with problems with autonomic function, it is useful to review a few things about the ANS. Readers will remember that the ANS helps us maintain physiological homeostasis: a stable state, even with changing environments. Structurally, the ANS operates under the control of the hypothalamus and uses networks comprised mostly of motor neurons to do its work. Some of these neurons extend directly from the brain into the body, packaged in cranial nerves. Others emerge from the spinal cord, encased in spinal nerves. Functionally, the ANS provides motor signals to muscles and glands that allow us to respond to our environment—and we do this at levels below conscious thought or voluntary action. Autonomic neurons help regulate heart rate, respiratory rate, blood pressure, digestion, and myriad other processes that keep us 36 m a s s a g e & b o d y w o r k j a n u a r y / f e b r u a r y 2 0 2 0

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