Autonomic dysfunction: investigations
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Autonomic dysfunction: investigations. Suspected autonomic neuropathy, Distressing small fiber neuropathy. Fully referenced neurology checklist.
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
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Neurotransmitter levels
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Cardiovascular tests
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Other tests
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References
- 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.
- Anon. Assessment: clinical autonomic testing: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 1996; 46:873-880.
- Mathias CJ. Autonomic diseases: clinical features and laboratory evaluation. JNNP 2003; 74(Suppl III):iii31–iii41.
- Zygmunt A, Stanczyk J. Methods of evaluation of autonomic nervous system function. Arch Med Sci 2010; 6:11–18.
- 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.
