A Case Report on Acute to Subacute Panautonomic Polyneuropathy: Presenting as a Gastrointestinal Motility Disorder / 대한소화관운동학회지

ABSTRACT

The acute to subacute panautonomic polyneuropathy is an uncommon peripheral nerve disease, including (1) acute to subacute onset, (2) widespread and severe sympathetic and parasympathetic failure, and (3) relative or complete sparing of somatic nerve fibers. Widespread sympathetic failure is manifested as severe orthostatic hypotension, anhidrosis, and parasympathetic failure, as indicated dry eyes, dry mouth, and disturbances of bowel and bladder function. Abdominal pain, often colicky, is very common, and gastrointestinal symptoms, such as early satiety, bloating, nausea, vomiting, pain, diarrhea, or alterating constipation and diarrhea, may persist for years. Patients usually have a fixed heart rate (HR) and pupils. There may be an antecedent viral infection but the frequency of infection is unknown. Little information is available on the course and prognosis of panautonomic neuropathy. The mainstay of treatment is supportive for the management of orthostatic hypotension, and bowel and bladder symptoms. We have examined a 66-year-old woman complaining epigastric pain, orthostatic hypotension and voiding difficulty, and we report a case of acute to subacute panautonomic neuropathy presenting as gastrointestinal symptoms.