Autonomic Nervous System Disorders: Symptoms and Solutions - Neurology

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Severe autonomic nervous system dysfunction?


Dear Doctor,
I have read a lot of relevant information and would like to focus on my daily routine and dietary intake.
I would also like to explain my symptoms.
In recent years, I have developed a strong liking for very spicy food, to the point where I feel unsatisfied without it.
This is a minor issue compared to what followed.
Since last year, I have been experiencing frequent vivid dreams and shallow sleep.
At that time, I felt unusually excited, and despite seeing a doctor, no cause was found.
I was prescribed medication for a mild cold, which was fine, but after finishing the medication, I developed stomach pain.
However, I recovered after taking more medication.
A few months later, the problems returned.
I thought it was stomach pain again, so I took over-the-counter antacids, which helped.
Then I experienced sleep deprivation and unusual excitement again.
In the past, I also had episodes of dizziness after soaking in hot water for too long, which resolved after using a fan for over 30 minutes.
I suspected it was due to the hot water, and I did not experience any discomfort afterward.
On the evening of April 14, 2012, after taking a warm shower, I experienced dizziness, nausea, weakness in my limbs, difficulty breathing, and swallowing.
I sat on the edge of the bathtub for nearly 10 minutes before I could slowly walk to my room.
During that short walk, I experienced dizziness to the point of not being able to see, but I was fully aware of my surroundings.
Once in my room, I sat on the edge of my bed with a fan on, unable to move for almost 10 minutes before I felt normal again.
Although I felt better, I had lingering symptoms that could be described as sequelae.
After that incident, everything seemed normal until the next morning when I woke up feeling dizzy, as if my blood pressure was unstable.
By noon, I began to experience an abnormal rise in body temperature that wouldn't go down, palpitations, chest tightness, difficulty breathing, and a rapid heartbeat (over 80 beats per minute, sometimes approaching 90).
After enduring these symptoms for a few days, I decided to see a doctor.
The initial diagnosis was tachycardia and high blood pressure.
An electrocardiogram and blood tests were performed, and the doctor noted two possibilities: palpitations and autonomic nervous system dysfunction.
He prescribed medication for angina and hypertension to be taken after breakfast and dinner, along with an anti-anxiety medication to be taken before bed.
After taking the medication, I felt somewhat better and thought I would be fine.
However, two days later, I returned for a follow-up.
This time, the doctor reviewed my chest X-ray and blood test results and confidently stated that everything was completely normal.
There were no abnormalities in my chest, and my heart appeared to be in excellent condition.
I was taken aback; if everything was normal, why was I experiencing these issues? I continued to report symptoms of chest tightness, palpitations, and difficulty breathing, and the doctor prescribed the same medication again, this time increasing the dosage to three times a day.
After taking it, I felt slightly better, but the next day, I noticed something was wrong.
My heart rate was so slow that I felt extremely dizzy.
I decided to stop the medication and see the doctor again.
This was my third visit.
I expressed my concerns about the medication to another highly regarded doctor and showed him my chest X-ray and blood test results, which he confirmed were normal, including normal thyroid function.
I directly asked if it could be autonomic nervous system dysfunction, as the diagnosis indicated no abnormalities despite my symptoms.
I insisted that since my heart was fine, I did not want to take this medication, especially since it seemed to have adverse effects.
I also mentioned that whenever I felt nervous or excited, my heart rate would increase, leading to difficulty breathing.
I explained that I had not slept the previous night due to heightened emotions and excitement, which made it impossible to fall asleep.
Consequently, he prescribed Alprox 0.5 mg to be taken twice a day for three days, followed by another five days at the same dosage, with the indication for anxiety and a noted side effect of dizziness.
On my third visit on April 30, after taking the medication, I slept from 2 PM to 7 PM.
After dinner, I took another dose and slept from 8 PM to 11 PM, then again from 2 AM to 7 AM.
Upon waking, I experienced pain at the back of my head.
After starting the medication, I found myself uncontrollably falling asleep in the afternoon, which led to insomnia on the night of May 1, continuing until the early hours of May 4.
I lay with my eyes closed, unable to stop my mind from racing with thoughts.
On the morning of May 4, I woke up feeling like my heart was out of control; any movement caused it to race.
I also experienced dizziness and eye pain.
I posted related questions on Yahoo Knowledge, but the responses seemed generic and unhelpful.
I desperately need a doctor's advice as I feel like I'm on the brink of collapse.
Please, I beg you to help me.

Nai Zhong, 20~29 year old female. Ask Date: 2012/05/04

Dr. Gao Chunde reply Neurology


It seems that there may be symptoms of anxiety and even approaching panic attacks.
This can be examined in daily life to identify any specific external causes, such as dietary factors, work, family, or other stressors.
If no external causes are found, it may be related to intrinsic characteristics of the body.
External factors are generally easier to address; once identified, changes can be made.
For intrinsic factors, professional psychological counseling or medication may be necessary.
However, I sense that you are very sensitive to medications, so it is crucial to inform your next physician about these reactions.
This way, if I were the one prescribing, I would choose the medication and dosage more precisely, tailoring it to your needs.
I also recommend minimizing exposure to highly stimulating foods, as well as avoiding television, movies, computers, and video games within two hours before bedtime.
Engage in outdoor activities during the day, and when you feel tired in the evening, go to bed to rest.

Reply Date: 2012/05/04

More Info


Understanding autonomic nervous system (ANS) disorders and their symptoms can be quite complex, especially when intertwined with anxiety and other psychological factors. Based on your detailed description, it seems you are experiencing a range of symptoms that could be attributed to dysregulation of the autonomic nervous system, which is responsible for involuntary bodily functions such as heart rate, digestion, and respiratory rate.

The autonomic nervous system is divided into two main branches: the sympathetic nervous system (SNS), which prepares the body for 'fight or flight' responses, and the parasympathetic nervous system (PNS), which promotes 'rest and digest' activities. When these systems are out of balance, it can lead to various physical and psychological symptoms, including anxiety, heart palpitations, dizziness, and gastrointestinal issues.

Your symptoms, such as heart palpitations, difficulty breathing, and feelings of dizziness or faintness, particularly after certain activities like bathing or prolonged exposure to heat, suggest that your body may be reacting to stressors in a way that is causing an overactivation of the sympathetic nervous system. This can lead to a state of heightened arousal, where your body is in a constant state of alertness, which is often seen in anxiety disorders.

The fact that you have experienced relief from some symptoms after taking medications indicates that there may be a component of anxiety or panic disorder involved. Medications like anti-anxiety drugs (e.g., Alprox) can help manage the symptoms by calming the nervous system, but they may also come with side effects, such as drowsiness or dizziness, which you have experienced. It’s essential to communicate these side effects to your healthcare provider, as they may need to adjust your medication or explore alternative treatments.

In addition to medication, lifestyle modifications can play a significant role in managing autonomic nervous system disorders. Here are some strategies that may help:
1. Stress Management Techniques: Practices such as mindfulness, meditation, and yoga can help reduce stress and promote relaxation, which may help balance the autonomic nervous system.

2. Regular Exercise: Engaging in regular physical activity can improve overall health and help regulate the autonomic nervous system. Aim for moderate exercise, such as walking or swimming, which can be beneficial without overstressing your body.

3. Healthy Diet: A balanced diet rich in whole foods, including fruits, vegetables, lean proteins, and whole grains, can support overall health. Avoiding excessive caffeine and spicy foods may also help reduce symptoms.

4. Sleep Hygiene: Establishing a regular sleep routine and creating a restful environment can improve sleep quality. If you find it difficult to sleep due to racing thoughts, consider relaxation techniques before bed.

5. Hydration and Temperature Regulation: Staying hydrated and avoiding extreme temperatures can help prevent symptoms like dizziness and faintness.

6. Cognitive Behavioral Therapy (CBT): This form of therapy can be effective in addressing anxiety and its physical manifestations. A mental health professional can help you develop coping strategies for managing anxiety and its symptoms.

7. Regular Follow-ups: Continue to work closely with your healthcare providers, including your primary care physician, neurologist, and psychiatrist, to monitor your symptoms and adjust your treatment plan as necessary.

In conclusion, while your symptoms may be distressing and complex, understanding the interplay between anxiety and autonomic nervous system function can guide effective management strategies. It’s crucial to maintain open communication with your healthcare team to ensure that you receive comprehensive care tailored to your needs. Remember that recovery is a process, and with the right support and strategies, you can work towards feeling better.

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