Autonomic Dysfunction in Neuromyelitis Optica and NMO Spectrum Disorders – A Prospective Observational Study.

Murthy, T V (2014) Autonomic Dysfunction in Neuromyelitis Optica and NMO Spectrum Disorders – A Prospective Observational Study. Doctoral thesis, Christian Medical College, Vellore.

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Abstract

INTRODUCTION : In NMO and spectrum disorders which has predilection for the critical areas in the brain and spinal cord causing Autonomic disturbances leading to varied autonomic dysfunction. AIMS AND OBJECTIVES : To assess the frequency, severity and spectrum of autonomic dysfunction in patients with Neuromyelitis optica and spectrum disorders. MATERIAL and METHODS : 20 patients studied by using Revised Criteria for NMO and spectrum disorders (2006). The autonomic dysfunction was assessed both autonomic symptoms(using COMPASS score) and autonomic function tests (Finopress TM) were done. The limited CASS score utilised for estimation of severity of autonomic dysfunction as the SSR was not available in all patients. The frequency and severity of autonomic dysfunction was estimated using the both autonomic symptoms and autonomic function tests. RESULTS : 20 Patients (13 females, males) showed autonomic dysfunction 95% during the active phase of the disease and 80% at the time of remission. The most common autonomic symptoms were of gastrointestinal, genitourinary, sudomotor and sexual dysfunction. On AFT tests the parasympathetic dysfunction(80%) predominantly involved than sympathetic (65%). The autonomic dysfunctions not correlating with the disease duration or EDSS score at remission, due to low EDSS scores at admission. CONCLUSION : The prevalence of Autonomic symptoms very high in Neuromyelitis Optica and Spectrum disorders. Autonomic function test abnormalities are found in 80% of patients during remission and 95% during the active phase. The parasympathetic cardiovascular abnormality rates (80%) more common than sympathetic cardiovascular function abnormality (65%). There was correlation between between EDSS scores at active phase with MRI changes due to involvement specific areas of brain and spinal cord(hypothalamus, area postrema, midbrain and periventricular areas).

Item Type: Thesis (Doctoral)
Uncontrolled Keywords: Autonomic Dysfunction ; Neuromyelitis Optica ; NMO Spectrum Disorders ; A Prospective Observational Study.
Subjects: MEDICAL > Neurology
Depositing User: Kambaraman B
Date Deposited: 30 Jun 2017 03:25
Last Modified: 30 Jun 2017 06:40
URI: http://repository-tnmgrmu.ac.in/id/eprint/691

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