Autonomic dysfunction in patients with non-alcoholic chronic liver disease

Oliver, María; Miralles, Ramón; Rubiés-Prat, J; Navarro, Xavier; Espadaler, Josep M.; Solá, Ricard; Andreu, Montserrat

doi:10.1016/s0168-8278(97)80458-8

Cited by 65 publications

(50 citation statements)

References 28 publications

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“…Also in diabetic neuropathy cardiac vagal, sudomotor, and small afferent fibers have been found to be involved simultaneously [22]. In nonalcoholic chronic liver disease a high prevalence of abnormalities in both sympathetic sudomotor and cardiac parasympathetic function tests has been shown, indicating that these systems are affected in parallel [16].…”

Section: Comparison Of the Function Of Different Small Fiber Systemsmentioning

confidence: 99%

Quantitative assessment and correlation of sympathetic, parasympathetic, and afferent small fiber function in peripheral neuropathy

Schuller¹,

Hermann²,

Baron³

2000

Journal of Neurology

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We compared three neurophysiological methods for assessing small nerve fiber function in 40 patients with peripheral neuropathy to determine the various manifestation types of peripheral small fiber neuropathy. Heart rate variation tests were used to assess cardiac parasympathetic small fiber function. Cutaneous vasoconstrictor responses (sympathetic C fibers) induced by deep inspiration were examined with laser Doppler flowmetry. Cutaneous afferent C fiber function was assessed by measurement of axon reflex vasodilatation induced by histamine iontophoresis. All test parameters were significantly lower in patients with peripheral neuropathy than in control subjects. Comparison of the three small fiber systems revealed that functionally different systems are damaged independently, and isolated affection of each fiber type was frequently observed. The three tests are useful noninvasive tools with which to evaluate sympathetic, parasympathetic, and afferent small fiber function in patients with peripheral neuropathy. In many patients functionally different small fiber systems are affected selectively. To diagnose small fiber neuropathy and to evaluate the individual type of manifestation complementary testing of several small somatic and autonomic fiber systems is necessary.

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Section: Comparison Of the Function Of Different Small Fiber Systemsmentioning

confidence: 99%

Quantitative assessment and correlation of sympathetic, parasympathetic, and afferent small fiber function in peripheral neuropathy

Schuller¹,

Hermann²,

Baron³

2000

Journal of Neurology

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“…There is also an association with autonomic neuropathy. 60,61,80,112,169,172 One study found autonomic neuropathy in 48% of patients with end-stage liver disease. 26 The normal tilt-table response of blood pressure and decreased variability of heart rate with deep breathing and Valsalva maneuver were suggestive of predominantly parasympathetic dysfunction.…”

mentioning

confidence: 99%

Neuromuscular diseases and disorders of the alimentary system

2002

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This review outlines the relationship and interaction between neuromuscular diseases and disorders of the alimentary system. Neuromuscular manifestations of gastrointestinal and hepatobiliary diseases are first considered. Such diseases may cause neuromuscular disorders by leading to nutritional deficiency or by more direct mechanisms. The pathogenesis, clinical features, and treatment of these various neuromuscular manifestations are discussed. The impact of disorders of nerve, neuromuscular transmission, and muscle on the alimentary system is then reviewed. The main sequelae are impaired deglutition and gastrointestinal dysmotility. The management of these complications is considered.

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“…In addition, autonomic dysfunction is frequently seen in patients with various levels of liver disease [53], including early stages [54][55][56][57][58][59], and may manifest as frequent falls, blackouts, orthostatic hypotension, and syncope. It has also been linked to sudden cardiac death and mortality [53].…”

Section: Cardiac and Autonomic Abnormalitiesmentioning

confidence: 99%