Autonomic Neurology Services

Autonomic disorders lead to a variety of symptoms including dizziness upon standing, fatigue, positional weakness, brain fog, constipation, urinary and sexual dysfunction, dry mouth or eyes, excessive salivation, excessive or lack of sweating, cold or hot intolerance, numbness and pain. Some symptoms improve when an underlying disease is treated otherwise specific treatments are recommended to address a patient’s symptoms.

We evaluate and treat the following common autonomic disorders:

  • Autonomic neuropathy/autonomic failure
  • Postural tachycardia syndrome
  • Small fiber neuropathy
  • Multiple system atrophy
  • Genetic disorders associated with dysautonomia
  • Diabetic neuropathy
  • Sweat disorders: anhidrosis (loss of sweating) or hyperhidrosis (excessive sweating)
  • Syncope
  • Cerebral blood flow abnormalities

We offer comprehensive evaluation and second opinion consultations for patients with suspected autonomic disorders.

  • Quantitative autonomic screening tests such as deep breathing, Valsalva maneuver, tilt test and sweat tests.
  • Skin biopsies of small epidermal and sweat gland fibers to determine the presence of small fiber neuropathy as well as its severity.
  • Continuous cerebral blood flow recordings during the tilt test are helpful in establishing the causes of dizziness.
  • Genetic testing and neuronal autoimmune profiles may be obtained if certain autonomic disorders are suspected.

The Autonomic Testing Lab is located at Brigham and Women’s Faulkner Hospital.

Treatment plans are tailored to each patient’s diagnosis. Treatment usually includes a combination of diet, exercise and medication. We also offer botulinum toxin (Botox®) therapy for hyperhidrosis or excessive sweating.

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