Dysautonomia is not one diagnosis but is a constellation of diagnoses that fall somewhere on the spectrum we call, “The Dysautonomia Universe.” The dysautonomia universe categorizes dysautonomias according to age group.
Dysautonomia isn’t one thing. It’s many scores of things. I think of dysautonomias as a universe, a constellation, of abnormalities. Then I break them down into pediatric, adult and geriatric. Of course, there is a lot of overlap, but I think it’s worthwhile in general thinking about this.
If somebody has a pediatric dysautonomia, there is I think a greater chance of a genetic or developmental problem of the autonomic nervous system. In an adult, more likely that there’s a functional abnormality. By functional I mean that the apparatus is there, the autonomic nervous system is there, but it’s not being regulated right. And finally, in the geriatric population, there’s an actual loss of autonomic nerve fibers or other factors that cause deficiency of the neurotransmitter.
David S. Goldstein, M.D., Ph.D
Chief, Autonomic Medicine Section
NINDS, National Institutes of Health