Autonomic Nervous System Disorders: Symptoms and Solutions - Psychiatry

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Autonomic nervous system dysfunction?


Hello, I would like to ask the doctor about my symptoms of palpitations and a sensation of body tremors.
I went to see a cardiologist and had an electrocardiogram, chest X-ray, and thyroid function tests, and the doctor said everything was normal.
I was prescribed medications (Atenolol and Clonazepam) and after taking them for three days, I noticed some improvement.
Prior to this, I had a sensation of something stuck in my throat and gastroesophageal reflux, but after taking the medications prescribed by the cardiologist, those symptoms improved.
However, once I stopped the medication, the palpitations and muscle twitching returned, and my muscles continue to tremble, making it difficult to sleep at night.
I would like to ask the doctor if it is necessary to continue the medication? Should I get an electromyography (EMG) or undergo other tests? The sensation of twitching is very uncomfortable for me.
😵‍💫

Amanda, 30~39 year old female. Ask Date: 2024/06/09

Dr. Xue Gengming reply Psychiatry


We recommend that you discuss the above situation further with your attending physician.
Thank you, and wishing you good health!

Reply Date: 2024/06/09

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Understanding Autonomic Nervous System Disorders: Symptoms and Solutions
Hello! Based on your description, it sounds like you are experiencing a range of symptoms that may be related to autonomic nervous system (ANS) dysfunction. The autonomic nervous system is responsible for regulating involuntary bodily functions, including heart rate, digestion, respiratory rate, and more. When this system is not functioning properly, it can lead to various symptoms, including palpitations, muscle twitching, and a sensation of body swaying or dizziness.

Your symptoms of palpitations and muscle twitching, along with the feeling of a lump in your throat and gastroesophageal reflux, suggest that there may be an interplay between your autonomic nervous system and gastrointestinal issues. It’s not uncommon for individuals with anxiety or stress to experience physical symptoms that can mimic or exacerbate gastrointestinal problems. The medications you were prescribed, such as anxiolytics, may have provided some relief by addressing the anxiety component, which can often contribute to autonomic dysregulation.

When you mentioned that stopping the medication led to a return of your symptoms, it raises the question of whether your symptoms are primarily driven by anxiety or if there is an underlying physiological issue that needs to be addressed. It’s important to note that while medications can be effective in managing symptoms, they may not always address the root cause of the problem.

In terms of next steps, it would be advisable to consult with a neurologist or a specialist in autonomic disorders. They may recommend additional tests, such as an electromyogram (EMG) to assess muscle activity and rule out any neuromuscular disorders. This could help clarify whether your muscle twitching is related to nerve function or if it is more likely a benign phenomenon associated with anxiety.

Additionally, lifestyle modifications can play a significant role in managing autonomic dysfunction. Stress management techniques, such as cognitive-behavioral therapy (CBT), mindfulness meditation, and regular physical activity, can help improve your overall well-being and potentially reduce the frequency and intensity of your symptoms. Ensuring adequate hydration, a balanced diet, and regular sleep patterns can also support autonomic function.

If your symptoms persist despite these interventions, it may be worth exploring other treatment options, including physical therapy or alternative therapies such as acupuncture, which some patients find beneficial for managing chronic symptoms.

In summary, while your symptoms may be indicative of autonomic nervous system dysfunction, a comprehensive evaluation by a specialist is essential to determine the underlying causes and appropriate treatment options. It’s important to address both the physical and psychological aspects of your symptoms to achieve the best possible outcome. Don’t hesitate to reach out for further evaluation and support as you navigate this challenging situation. Your health and comfort are paramount, and there are pathways to improvement.

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