Clinical and electrophysiologic attributes as predictors of results of autonomic function tests

Chia Lun Wu, Jong Chyou Denq, C. Michel Harper, Peter C. O'Brien, Phillip A. Low

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Autonomic dysfunction is a feature of some neuropathies and not others. It has been suggested that some clinical and electrophysiologic attributes are predictable of autonomic impairment detected using laboratory testing; however, clear guidelines are unavailable. We evaluated 138 relatively unselected patients with peripheral neuropathy who underwent neurologic evaluation, electromyography (EMG), nerve conduction studies, and autonomic function tests to determine which variables were predictive of laboratory findings of autonomic failure. The variables evaluated were 1) clinical somatic neuropathic findings, 2) clinical autonomic symptoms, and 3) electrophysiologic findings. Autonomic symptoms were strongly predictive (R(s) = 0.40, p < 0.001) of autonomic failure. Among the non-autonomic indices, absent ankle reflexes were mildly predictive (R(s) = 0.19, p = 0.022) of autonomic impairment, but all others were not (duration, clinical pattern, severity, weakness, sensory loss). Electrophysiologic changes of an axonal neuropathy predicted autonomic impairment while demyelinating neuropathy did not. We conclude that autonomic studies will most likely be abnormal in patients who have symptoms of autonomic involvement and those who have an axonal neuropathy.

Original languageEnglish (US)
Pages (from-to)347-351
Number of pages5
JournalClinical Autonomic Research
Volume8
Issue number6
DOIs
StatePublished - Dec 1 1998

Keywords

  • Autonomic
  • EMG
  • Laboratory
  • Neuropathy
  • Symptoms

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology

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