eMedicine Specialties > Neurology > Movement and Neurodegenerative Diseases

Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes: Follow-up

Author: Jeffrey Tam Sing, MD, Consulting Physician, Neurology of the Rockies, Parker, Colorado
Coauthor(s): Bjorn E Oskarsson, MD, Assistant Professor, Department of Neurology, University of California Davis; Dianna Quan, MD, Associate Professor of Neurology, Director, Electromyography Laboratory, University of Colorado Health Sciences Center
Contributor Information and Disclosures

Updated: Nov 18, 2009

Follow-up

Further Inpatient Care

  • Physical therapy is useful for gait training. Patients also should be instructed in safety precautions.
  • Patients should be monitored closely for drug efficacy and adverse effects. Doses should be adjusted accordingly.

Prognosis

  • The prognosis for autoimmune autonomic neuropathy (AAN) is poor without treatment, and many patients have residual autonomic symptoms. With IVIg therapy, a few patients who are treated early in the disease course can have excellent recovery of function. However, additional patients must be treated to confirm the initial favorable findings.
  • Patients with pure autonomic failure have symptoms that remain confined to the autonomic nervous system. These patients generally improve little over time, and their symptoms may worsen. Some may later develop multiple system atrophy or Parkinson's disease.
  • The prognosis for patients with multiple system atrophy is poor overall. Neurologic function declines gradually over time. The autonomic symptoms often become debilitating. Survival is typically 6-9 years from the time of diagnosis.

Miscellaneous

Medicolegal Pitfalls

  • Failure to diagnose and treat acute inflammatory demyelinating polyneuropathy
  • Failure to detect an associated malignancy at the time of presentation
  • Failure to prevent fatal cardiac events
 


More on Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes

Overview: Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes
Differential Diagnoses & Workup: Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes
Treatment & Medication: Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes
Follow-up: Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes
References
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References

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Further Reading

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Keywords

acute idiopathic dysautonomia, multiple system atrophy, olivopontocerebellar atrophy, pure autonomic failure, Shy-Drager syndrome, striatonigral degeneration, postural tachycardia syndrome, autoimmune autonomic neuropathy, autoimmune autonomic ganglionopathy, acute pandysautonomia, acute panautonomic neuropathy

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Contributor Information and Disclosures

Author

Jeffrey Tam Sing, MD, Consulting Physician, Neurology of the Rockies, Parker, Colorado
Jeffrey Tam Sing, MD is a member of the following medical societies: American Academy of Neurology and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Bjorn E Oskarsson, MD, Assistant Professor, Department of Neurology, University of California Davis
Bjorn E Oskarsson, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

Dianna Quan, MD, Associate Professor of Neurology, Director, Electromyography Laboratory, University of Colorado Health Sciences Center
Dianna Quan, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and Phi Beta Kappa
Disclosure: e-medicine Honoraria Other

Medical Editor

Christopher Luzzio, MD, Clinical Assistant Professor, Department of Neurology, University of Wisconsin at Madison
Christopher Luzzio, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Neil A Busis, MD, Chief, Division of Neurology, Department of Medicine, Head, Clinical Neurophysiology Laboratory, University of Pittsburgh Medical Center-Shadyside
Neil A Busis, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

Chief Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

 
 
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