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General Neurology

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Abstract

In this chapter, we finish presenting the P&S data we have to date on the remainder of the fields within neurology, including Parkinson’s disease, multiple system atrophy, pure autonomic failure, multiple sclerosis, epilepsy, unexplained seizures, abnormal sweating, and Sörgren’s disease. P&S monitoring, in large part, had its start in cardiology and was significantly promoted in endocrinology (specifically diabetology). However, it is hoped that in bringing more information to light regarding a largely, heretofore, unmeasured portion of the nervous system, neurology will accelerate its growth. The purpose of P&S monitoring is to augment the field of autonomic nervous system monitoring, not to replace anything. P&S monitoring has its role. It is an easy to implement, apply, and utilize tool to assess, treat, and maintain patients who are known to be at risk for autonomic neuropathy before autonomic neuropathy is demonstrated. There is a point beyond which P&S monitoring is no longer effective, because at the level of the heart, there is not enough autonomic function remaining to be measured. It is at this point that traditional autonomic tests, including tilt table, become more effective. Several of the patient types that typically push the limits of P&S monitoring are presented in this section and include patients with advanced Parkinson’s, advanced multiple system atrophy, pure autonomic failure, and severe tremors and movement disorders.

Keywords

  • Orthostatic Hypotension
  • Multiple System Atrophy
  • Vagus Nerve Stimulation
  • Cardiovascular Autonomic Neuropathy
  • Multiple System Atrophy Patient

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Goldstein DS, Sewell L, Holmes C, Sharabi Y. Is Parkinson disease with orthostatic hypotension a distinctive entity? In: Presented at the 21st international symposium of the American Autonomic Society, Marco Island, 3–6 Nov 2010.

    Google Scholar 

  2. Goldstein DS. Cardiac sympathetic neuroimaging to distinguish multiple system atrophy from Parkinson disease. Clin Auton Res. 2001;11(6):341–2.

    CAS  PubMed  CrossRef  Google Scholar 

  3. Goldstein DS. Cardiac denervation in patients with Parkinson disease. Cleve Clin J Med. 2007;74 Suppl 1:S91–4.

    PubMed  CrossRef  Google Scholar 

  4. Goldstein DS, Orimo S. Cardiac sympathetic neuroimaging: summary of the First International Symposium. Clin Auton Res. 2009;19(3):137–48. Epub 2009 Mar 6.

    PubMed Central  PubMed  CrossRef  Google Scholar 

  5. Imrich R, Eldadah BA, Bentho O, Pechnik S, Sharabi Y, Holmes C, Grossman E, Goldstein DS. Functional effects of cardiac sympathetic denervation in neurogenic orthostatic hypotension. Parkinsonism Relat Disord. 2009;15(2):122–7. Epub 2008 May 29.

    PubMed Central  PubMed  CrossRef  Google Scholar 

  6. Goldstein DS, Holmes C, Bentho O, Sato T, Moak J, Sharabi Y, Imrich R, Conant S, Eldadah BA. Biomarkers to detect central dopamine deficiency and distinguish Parkinson disease from multiple system atrophy. Parkinsonism Relat Disord. 2008;14(8):600–7. Epub 2008 Mar 5.

    PubMed Central  PubMed  CrossRef  Google Scholar 

  7. Moak JP, Goldstein DS, Eldadah BA, Saleem A, Holmes C, Pechnik S, Sharabi Y. Supine low-frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation. Cleve Clin J Med. 2009;76 Suppl 2:S51–9.

    PubMed  CrossRef  Google Scholar 

  8. Rahman F, Pechnik S, Gross DJ, Sewell L, Goldstein DS. Respiration-adjusted low frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation. In: Presented at the 21st international symposium of the American Autonomic Society, Marco Island, 3–6 Nov 2010.

    Google Scholar 

  9. Keselbrener L, Akselrod S, Ahiron A, Eldar M, Barak Y, Rotstein Z. Is fatigue in patients with multiple sclerosis related to autonomic dysfunction? Clin Auton Res. 2000;10(4):169–75.

    CAS  PubMed  CrossRef  Google Scholar 

  10. Zaaimi B, Grebe R, Berquin P, Wallois F. Vagus nerve stimulation induces changes in respiratory sinus arrhythmia of epileptic children during sleep. Epilepsia. 2009;50(11):2473–80.

    PubMed  CrossRef  Google Scholar 

  11. Schuele SU. Effects of seizures on cardiac function. J Clin Neurophysiol. 2009;26(5):302–8.

    PubMed  CrossRef  Google Scholar 

  12. Mukherjee S, Tripathi M, Chandra PS, Yadav R, Choudhary N, Sagar R, Bhore R, Pandey RM, Deepak KK. Cardiovascular autonomic functions in well-controlled and intractable partial epilepsies. Epilepsy Res. 2009;85(2–3):261–9.

    PubMed  CrossRef  Google Scholar 

  13. Jehi L. Sudden death in epilepsy, surgery, and seizure outcomes: the interface between heart and brain. Cleve Clin J Med. 2010;77 Suppl 3:S51–5.

    PubMed  CrossRef  Google Scholar 

  14. Sevcencu C, Struijk JJ. Autonomic alterations and cardiac changes in epilepsy. Epilepsia. 2010;51(5):725–37.

    PubMed  CrossRef  Google Scholar 

  15. Bealer SL, Little JG, Metcalf CS, Brewster AL, Anderson AE. Autonomic and cellular mechanisms mediating detrimental cardiac effects of status epilepticus. Epilepsy Res. 2010;91(1):66–73.

    PubMed Central  PubMed  CrossRef  Google Scholar 

  16. Jansen K, Lagae L. Cardiac changes in epilepsy. Seizure. 2010;19(8):455–60.

    CAS  PubMed  CrossRef  Google Scholar 

  17. Chroni E, Sirrou V, Trachani E, Sakellaropoulos GC, Polychronopoulos P. Interictal alterations of cardiovagal function in chronic epilepsy. Epilepsy Res. 2009;83(2–3):117–23.

    PubMed  CrossRef  Google Scholar 

  18. Harreby KR, Sevcencu C, Struijk JJ. Ictal and peri-ictal changes in cervical vagus nerve activity associated with cardiac effects. Med Biol Eng Comput. 2011;49(9):1025–33.

    PubMed  CrossRef  Google Scholar 

  19. Jansen K, Vandeput S, Milosevic M, Ceulemans B, Van Huffel S, Brown L, Penders J, Lagae L. Autonomic effects of refractory epilepsy on heart rate variability in children: influence of intermittent vagus nerve stimulation. Dev Med Child Neurol. 2011;53(12):1143–9.

    PubMed  CrossRef  Google Scholar 

  20. Tobias H, Vinitsky A, Bulgarelli RJ, Ghosh-Dastidar S, Colombo J. Autonomic nervous system monitoring of patients with excess parasympathetic responses to sympathetic challenges – clinical observations. US Neurol. 2010;5(2):62–6.

    Google Scholar 

  21. Nikolov NP, Patel A, Alba MI, Leakan R, Bebris L, Ghosh-Dastidar S, Colombo J, Illei GG. Dysautonomia in primary Sjögren’s syndrome patients as assessed in the outpatient setting using real-time digital autonomic nervous system monitoring. In: Presented at the American College of Rheumatology 2008 annual scientific meeting, San Francisco, 25–29 Oct 2008.

    Google Scholar 

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Colombo, J., Arora, R., DePace, N.L., Vinik, A.I. (2015). General Neurology. In: Clinical Autonomic Dysfunction. Springer, Cham. https://doi.org/10.1007/978-3-319-07371-2_26

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  • DOI: https://doi.org/10.1007/978-3-319-07371-2_26

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