"Annals of Neurology", Vol 21, No. 5, May 1987, 'Disorders of the
Autonomic Nervoous System: Part 1. Pathophysiology and Clinical
Features'
J.G. McLeod. DPhil, FRACP, and R.R. Tuck, PhD, FRACP--From the
Department of Neurology, Royal Prince Alfred Hospital, and the
Department of Medicine, University of Sydney, Sydney, NSW2006
Australia(Thumbs up to those from 'down under'! Hi, Errol.)
The following are excerpts that I feel are applicable and partially
understandable to everyone with TM
p421
"Direct recording in humans has shown that symopathetic nerve fiber
activity in muscles increases in response to a fall in blood
pressure[44]to changes in posture from the lying to sitting anfd
standing positions[31], and to the application of negative pressure to
the lower body, which is thought to unload intrathoracic low-pressure
volume receptors[173].".......
(My eyesight would get better when I was lying down.)
"Diseases of the Autonomic nervous system give rise to impaired control
of blood pressure; heart rate; sweating and temperature regualtion;
bowel; bladder, and sexual function; gastrointestinal tract; pupils; and
lacrimal glands."................
p 423
"Disorders Associated with Peripheral Neuropathy
The autonomic nervous system is affected in many peripheral
neuropathies[96,115,,116]. From a practical viewpoint, they may be
grouped into those in which autonomic dysfunction is clinically
important and may be a presenting feature, and those in whwich it is
mild and may often be unrecognized(see Table).".............
"Impaired sweating ability on the extremeties is common, probably
resulting from degeneration of the cholinergic postganglionic
sympathetic unmyelinated fibers that travel with peripheral nerves to
innervate sweat glands or demyelination of the preganglionic sympathetic
efferent fibers. Hyperhidrosis may be seen in partial nerve injuries
causing casualgia or when ther is pressure on the nerve root, which
occurs in malignancy [14,88,94] and in some toxic neuropathies
[14,88,99].When the ability to sweat is impaired on the extremeties,
excessive compensatiory sweating may occur on the trunk and
face.Orthostatic postural hypotension results from damage to
small-diameter myelinated and unmyelinated fibers in affferent and
efferent nerves in the baroflex pathways. Postural hypotension therefore
most commonly occurs in diabetes and amyloid disesase in which these
small fibers are affected and in acute inflammatory neuropathy when
segmental demylenation affects the myelinated autonomic fibers in the
vagus and sympathetic pathways. Orthostatic hypotension is most likely
to occur when fibers in the sphlanchnic vascular bed are pathologically
involved, since the latter plays an important part in blood pressure
regulation in humans [112,115,116]. Impaired control pof heart rate
results from vagal damage in patients with autonomic neuropathy,
particularly with diabetes [112,185].
Bladder dysfunction, impotence, and pupillary abnormalities are other
clinical manifestations of autonomic dysfunction in peripheral nerve
disease."
As I was reading, I saw the part about sweating which has been brought
up by others, so I included it.
I have been taking Clondine and it helps.
John, MD, GP {Manic Depressive, Guinea Pig(for baclofen pump)}
P.S. I limped for many years after I recovered from the paralysis. Every
doctor felt it was due to TM. After I got my baclofen pump and was
walking, the doctor was watching me walk. he then had me lie down and
measured from my navel to each ankle. My left leg was 5/8 of an inch
shorter than my right.
The doctor was Dr. Richard Herman, Rehab Medicine. He was Medical
Director of the Good Samaratin Rehab Institue in Phoenix at the time. He
did the blind study for the pump. He had spent 5 years at Temple, 5
years at Stanford and 5 years at Dartmouth.
P.P.S. I know should credit the references, but I am not a fast typist
and there are 177 references in Part 1 and over 188 in Part 2 of the
report. If anyone would like them, please let me know.