Dysautonomia is often found in young people. It is a dysfunction of the autonomic nervous system characterized by orthostatic intolerance (discomfort or dizziness when moving to a standing position after sitting or lying down) or postural tachycardia syndrome (POTS), an abnormally high increase in the heart rate. Many individuals also report symptoms such as dizziness, post-exertional malaise, palpitations, digestive problems (such as nausea, diarrhoea or abdominal pain), bladder incontinence or vision problems. These symptoms may be related to dysautonomia.
How do we test for it ?
A test by your paediatrician or primary care physician for orthostatic conditions (your blood pressure and heart rate will be measured for 10 minutes while lying down and standing up).
If the results of the physical examination and the basic tests are normal but there is still a strong suspicion that the patient may be suffering from dysautonomia, particularly if he or she experiences post-exertional malaise (an inability to recover after exerting oneself, even after minimal effort), other cardiological or neuropsychological tests, such as a tilt test, can be performed. In some cases, a Holter monitor can be used for 24–48 hours to detect changes in the heart rate at night or during the day.
How is it treated ?
Dysautonomia is difficult to treat and can have a significant impact on the individual’s quality of life.
You should first try non-drug treatments that focus on prevention and preserving energy levels, with regular check-ups.
Tips:
- Try not to get up quickly.
- Sleep in a semi-reclined position.
- Wear custom-made compression stockings (with a compression level rated higher than 30 mmHg).
- Ensure that your salt intake is between 6 and 10 grams a day.
- Stay well hydrated (drink 2–3 litres per day).
- Drink water before meals
- Have small, regular meals.
- Lie down after heavy meals
Medication is available as a second line of treatment, in addition to the non-pharmaceutical interventions. Medication is prescribed only in documented cases of dysautonomia, in consultation with a cardiologist or neurologist.
