Symptoms of Autonomic Nervous System Dysfunction

I feel like I have autonomic nervous system dysregulation?

Since June, I have been experiencing nasal congestion and difficulty breathing.
Initially, I was worried about being diagnosed with COVID-19, but I eventually realized that it was just nasal congestion that I hadn't noticed, which led to my breathing difficulties.
Starting on June 13, I began to experience some symptoms, including a sensation of a foreign body in my throat, feeling like something was blocking it.
Sometimes, I would also cough for no apparent reason.
On June 14, I felt palpitations.
From June 13 to June 14, I was lying in bed playing on my phone, and when I got up, I felt dizzy and my vision went black for about ten seconds before gradually recovering.
Recently, my hands have also felt very weak.
On June 16, after getting up, I felt extremely tired and went back to sleep, but the more I slept, the more I felt like I was on the verge of death, unable to catch my breath.
Finally, after about five minutes of being awake, that feeling went away.
Could all of these symptoms possibly be related to autonomic nervous system dysfunction?

Miss Yang, 10~19 year old female. Ask Date: 2021/06/16

Dr. Jiang Junyi reply Neurology

Dear Miss Yang,
Regarding your issue, we need to first consider the problem of syncope, particularly the experience of "seeing a black screen for over ten seconds before slowly recovering." The most common causes are reflex syncope, which can occur due to excessive stimulation of the vagus nerve, leading to bradycardia and decreased cardiac output.
This can happen when changing positions from lying down to standing, standing up suddenly after squatting, certain medications causing hypotension, significant blood volume loss, peripheral vasodilation in hot environments, or peripheral neuropathy.

Cardiac syncope should also be considered, such as arrhythmias, valvular heart disease, cardiac myxoma, acute myocardial infarction, or coronary artery spasm causing irregular heart rates and blood pressure drops.
Metabolic syncope, such as hypoglycemia or hyperventilation, should be differentiated from conditions like epilepsy and vertigo.
Generally, the autonomic nervous system is regulated by the sympathetic and parasympathetic nervous systems, where one acts as the accelerator and the other as the brake.
The sympathetic nervous system is responsible for increasing heart rate, accelerating breathing, and increasing sweat production during exercise.
Once the exercise stops, the parasympathetic nervous system takes over, slowing the heart rate, reducing breathing, and decreasing sweat production.
I recommend that you visit a neurology outpatient clinic for further evaluation.
However, due to the current COVID-19 pandemic situation, it is advisable to wait until the situation stabilizes before going to the hospital for examination.
Please ensure to implement self-protection measures, including cleaning and disinfecting, and adhere to new pandemic prevention practices before and after your medical visit.
Thank you for your inquiry.
If you have further questions, feel free to discuss them!
Wishing you good health and safety,
Dr.
Jiang Junyi, Taoyuan Hospital

Reply Date: 2021/06/16

More Info

Your symptoms indeed raise concerns that could be related to autonomic nervous system (ANS) dysfunction. The autonomic nervous system is responsible for regulating involuntary bodily functions, including heart rate, blood pressure, respiration, digestion, and sexual arousal. When this system is not functioning properly, it can lead to a variety of symptoms that can affect multiple systems in the body.

Understanding Your Symptoms
1. Nasal Congestion and Breathing Difficulties: Nasal congestion can lead to difficulty breathing, especially if it is severe enough to obstruct airflow. This can be exacerbated by anxiety, which is often linked to autonomic dysfunction. The feeling of not being able to breathe properly can trigger panic attacks, which may further complicate your symptoms.

2. Throat Sensation and Coughing: The sensation of a lump in the throat (often referred to as "globus sensation") can be associated with anxiety and stress, which can also affect the autonomic nervous system. This sensation can lead to coughing as a reflex to clear what feels like an obstruction.

3. Palpitations: Heart palpitations are a common symptom of autonomic dysfunction. They can occur due to increased sympathetic nervous system activity (the fight-or-flight response) or decreased parasympathetic activity (which calms the body down). This imbalance can lead to feelings of anxiety and panic, which may explain your experience of heart palpitations.

4. Dizziness and Lightheadedness: The episodes of dizziness and feeling faint when standing up could indicate orthostatic hypotension, a condition where blood pressure drops significantly upon standing. This is often related to autonomic dysfunction, where the body fails to regulate blood pressure effectively.

5. Fatigue and Weakness: Persistent fatigue and muscle weakness can also be symptoms of autonomic dysfunction. The body may struggle to maintain energy levels due to improper regulation of blood flow and oxygen delivery to tissues.

6. Feeling of Impending Doom: The sensation of feeling like you are "near death" or unable to breathe can be a manifestation of severe anxiety, which is often intertwined with autonomic dysfunction. This can create a vicious cycle where anxiety exacerbates physical symptoms, leading to more anxiety.

Potential Causes and Considerations
- Stress and Anxiety: High levels of stress and anxiety can lead to autonomic dysfunction. Psychological stress can trigger the sympathetic nervous system, leading to symptoms like palpitations and dizziness.

- Physical Health Conditions: Conditions such as allergies, respiratory infections, or even gastrointestinal issues can contribute to feelings of congestion and discomfort, which may further exacerbate anxiety and autonomic symptoms.

- Lifestyle Factors: Poor sleep, lack of physical activity, and unhealthy eating habits can also contribute to autonomic dysfunction.

Recommendations
1. Consult a Healthcare Provider: It is crucial to discuss your symptoms with a healthcare provider who can perform a thorough evaluation. They may recommend tests to assess your autonomic function, such as tilt table testing or heart rate variability analysis.

2. Manage Stress: Techniques such as mindfulness, meditation, and deep-breathing exercises can help manage anxiety and stress, potentially alleviating some of your symptoms.

3. Stay Hydrated and Nourished: Ensure you are drinking enough water and eating a balanced diet to support overall health and well-being.

4. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This information can be valuable for your healthcare provider in diagnosing and managing your condition.

5. Consider Therapy: Cognitive-behavioral therapy (CBT) or other forms of psychological support can be beneficial in managing anxiety and its physical manifestations.

In conclusion, your symptoms could very well be linked to autonomic nervous system dysfunction, but a comprehensive evaluation by a healthcare professional is essential for accurate diagnosis and effective treatment.

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