Autonomic Peripheral Neuropathy

Roy Freeman, MBChB Autonomic Disorders p. 58-71 February 2020, Vol.26, No.1 doi: 10.1212/CON.0000000000000825
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PURPOSE OF REVIEW This article provides a summary of the autonomic neuropathies, including neuropathies associated with diabetes mellitus, neuropathies due to amyloid deposition, immune-mediated autonomic neuropathies (including those associated with a paraneoplastic syndrome), inherited autonomic neuropathies, and toxic autonomic neuropathies. The presenting features, diagnostic investigations, and natural history of these neuropathies are discussed.

RECENT FINDINGS Recent findings in autonomic peripheral neuropathy include data on the epidemiology and atypical presentations of diabetic autonomic neuropathy, treatment-induced neuropathy of diabetes mellitus, the presentation of immune-mediated neuropathies, and advances in hereditary neuropathy associated with amyloidosis and other hereditary neuropathies.

SUMMARY Knowledge and recognition of the clinical features of the autonomic neuropathies, combined with appropriate laboratory and electrophysiologic testing, will facilitate accurate diagnosis and management.

Address correspondence to Dr Roy Freeman, Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, 1 Deaconess Rd, Boston, MA 02215, rfreeman@bidmc.harvard.edu.

RELATIONSHIP DISCLOSURE: Dr Freeman has received personal compensation and/or stock options for serving on scientific advisory boards of Abide Therapeutics; Applied Therapeutics, Inc; Aptinyx, Inc; Astellas Pharma; Biogen; Biohaven Pharmaceuticals; Chromocell; Cutaneous Neurodiagnostics, LLC; GW Pharmaceuticals, plc; Ironwood Pharmaceuticals; Lundbeck; Mundipharma; NeuroBo Pharmaceuticals; Novartis; Pfizer, Inc; Regenacy Pharmaceuticals; Spinifex Pharmaceuticals; Theravance Biopharma; Toray Medical Co, Ltd; and Vertex Pharmaceuticals. Dr Freeman has received personal compensation for serving as editor-in-chief of Autonomic Neuroscience: Basic & Clinical.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Freeman reports no disclosure.

© 2020 American Academy of Neurology.