Autonomic dysfunction: investigations

Evidence-based neurology checklist on autonomic dysfunction: investigations: Indications for autonomic testing Suspected autonomic neuropathy Distressing small fiber neuropathy Identifying life-threatening autonomic disorders Postural tachycardia syndrome Progressive autonomic neuropathy…

Indications for autonomic testing

  • Suspected autonomic neuropathy
  • Distressing small fiber neuropathy
  • Identifying life-threatening autonomic disorders
  • Postural tachycardia syndrome
  • Progressive autonomic neuropathy
  • Sympathetically maintained pain
  • Monitoring course of autonomic failure
  • Assessing response to treatment of autonomic dysfunction
  • Undiagnosed peripheral neuropathy (PN)

Core autonomic function tests

Neurotransmitter levels

Cardiovascular tests

Other tests

References

  1. England JD, Gronseth GS, Franklin G, et al. Practice Parameter: evaluation of distal symmetric polyneuropathy: role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review). Report of the American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and American Academy of Physical Medicine and Rehabilitation. Neurology 2009; 72:177-184.
  2. Anon. Assessment: clinical autonomic testing: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 1996; 46:873-880.
  3. Mathias CJ. Autonomic diseases: clinical features and laboratory evaluation. JNNP 2003; 74(Suppl III):iii31–iii41.
  4. Zygmunt A, Stanczyk J. Methods of evaluation of autonomic nervous system function. Arch Med Sci 2010; 6:11–18.
  5. Velucci V, De Pizzo F, Milella G, et al. Cardiac MIBG scintigraphy in pure autonomic failure: A systematic review. J Neurol Sci 2025; 478:123715.

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