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Cardiac autonomic dysfunction in rotogravure printers exposed to toluene in relation to peripheral nerve conduction.

The autonomic nervous effects of toluene remain less clear. To clarify this neurotoxicity, ten rotogravure printers and the same number of age-matched unexposed controls were examined, by using the coefficient of variation in electrocardiographic R-R intervals (CVRR), the distribution of nerve conduction velocities (DCV) and the maximal motor and sensory nerve conduction velocities (MCV and SCV) in the median nerve. Also, the C-CVHF and C-CVLF (two component CVs of the CVRR reflecting parasympathetic and sympathetic activities, respectively) were computed from component spectral powers using autoregressive spectral and component analyses. These printers had been exposed to toluene (estimated exposure levels of toluene at 83 ppm) for 1-36 years. The CVRR and C-CVHF were significantly lower in the printers than in the controls. No significant difference between the printers and the controls was found in either any DCV parameters or the SCV in the forearm, except the MCV and the SCV in the palm. In the light of previous work on the brainstem/hippocampus damages due to toluene, these data suggest that toluene causes potential damages in the central autonomic nervous system, mainly parasympathetic hypoactivity.

Adult

Age-dependent occurrence of autonomic dysfunction in chronic uraemia.

A battery of cardiovascular reflex tests were performed in twenty patients with chronic renal failure on intermittent haemodialysis. Using age-adjusted confidence limits, old-aged uraemics showed more extensive parasympathetic and sympathetic dysfunction than middle-aged patients. The results suggest that autonomic nervous system in the elderly is more susceptible to uraemic toxins than in the middle age. This should lead to better preventive and therapeutic strategies in older uraemics.

Adult

Occurrence of uraemic autonomic dysfunction in relation to age.

A battery of cardiovascular reflex tests were performed on 20 patients with chronic renal failure on intermittent haemodialysis, to assess occurrence of parasympathetic and sympathetic abnormalities. Using age-adjusted confidence limits, elderly uraemics showed more extensive parasympathetic and sympathetic dysfunction than middle-aged patients. The results suggest that the autonomic nervous system in the elderly is more susceptible to uraemic toxins than in the middle aged. This should lead to better preventive and therapeutic strategies for older uraemics.

Adult

R-R variations, a test of autonomic dysfunction.

Beat-to-beat variation of the heart rate was studied as a test of autonomic function. Recordings were made during quiet breathing, deep breathing and tilting from supine to upright position. The heart rate variations were expressed as a % of mean R-R interval. In order to establish normal criteria, the influence of age, wakefulness and intra-individual variations was studied in healthy volunteers. A negative correlation with age was found for all measured parameters. Patients with diabetic polyneuropathy differed from age-matched controls. Patients with symptoms of autonomic failure showed smaller variations than those without such symptoms.

Adult

[Autonomic dysfunction in metabolic diseases].

Among many metabolic disorders, porphyrias and Fabry disease are known to affect autonomic nervous system. In patients with acute intermittent porphyria, hereditary coproporphyria, and variegate porphyria, autonomic symptoms such as abdominal pain, vomiting, hypertension and tachycardia are among the most prominent clinical manifestations. Fabry disease is clinically characterized by severe limb pain, hypohidrosis, angiokeratomas and various autonomic symptoms. In both porphyrias and Fabry disease, pathological changes in the central and peripheral autonomic nervous system have been documented. In porphyrias, a loss of myelinated fibers, axonal degeneration, and segmental demyelination in peripheral autonomic nerves as well as chromatolysis of several brain stem nuclei have been found. In Fabry disease, abnormal amount of the substrates of alpha-galactosidase, i.e. ceramide di- and trihexoside, are found to be accumulated in the central and peripheral autonomic nerves.

Autonomic Nervous System Diseases

Cardiac autonomic dysfunction during sleep in some neurological diseases.

The most widely used tests for the investigation of the autonomic nervous system (ANS) functioning measure the heart rate (HR) variations during wakefulness. Most tests have some limitations: they require patient collaboration and can be modified by his or her emotional status. We studied HR variability in relation to body movements during sleep in some neurological diseases. Our method seems to be better than the traditional tests in detecting early cardiac ANS damage, especially when the patient is non-co-operative for ANS evaluation during wakefulness after various stimuli.

Adult

Autonomic dysfunction in botulism B: a clinical report.

Nine cases of botulism B with preponderant effects upon cholinergic autonomic innervation are presented. Blurred vision and dry mouth were constant symptoms. Impairment of salivary and lacrimal secretion were detectable for months. In the absence of clinical signs, electromyographic studies did not reveal neuromuscular involvement. Administration of antitoxin in the late course of such cases is not recommended, but guanidine can be used. Doubt is cast upon a new clinical entity called "acute autonomic neuropathy."

Adult