Autonomic neuropathies are peripheral nerve disorders with disproportionate involvement of autonomic fibers.
(See also Overview of the Autonomic Nervous System.)
The best known autonomic neuropathies are those accompanying peripheral neuropathy due to diabetes, amyloidosis, or autoimmune disorders.
Autoimmune autonomic neuropathy is an idiopathic disorder that often develops after a viral infection; onset may be subacute.
Autonomic insufficiency is usually a late manifestation in alcoholic neuropathy.
Other causes can include toxins, drugs, and paraneoplastic syndromes.
Diagnosis of autonomic neuropathy is based on demonstration of autonomic failure and of a specific cause of neuropathy (eg, diabetes, amyloidosis).
Autoimmune autonomic neuropathy may be suspected after a viral infection. Ganglionic anti–acetylcholine receptor antibody A3 is present in about half of patients with autoimmune autonomic neuropathy and is occasionally present in patients with other autonomic neuropathies.