Acute Pan-Dysautonomia with Recovery in a Patient with Chronic Renal Failure Treated by Intermittent Hemodialysis

Abstract

The association of acute pan-dysautonomia with recovery and chronic renal failure was reported. A 22 year-old uremic patient under treatment with intermittent hemodialysis presented with internal ophthalmoplegia, orthostatic hypotension, anhidrosis, miction syncope, loss of penile erectile function, abdominal pain, constipation and diarrhea. Investigation established the impairment of both peripheral sympathetic and parasympathetic fibers. A subclincal somatic neuropathy was evident from a depressed motor nerve conduction velocity. It appeared that recovery from autonomic dysfunction was concurrent with intermittent hemodialysis. Therefore, we discussed the possibility that the uremic neuropathy relates to an acute pan-dysautonomia.