David S. Goldstein, MD, PhD; David Robertson, MD; Murray Esler, MD; Stephen E. Straus, MD; Graeme Eisenhofer, PhD
In dysautonomias, altered function of the autonomic nervous system adversely affects health.
Norepinephrine ( ), dihydroxyphenylglycol ( ), and endogenous L-dopa are produced intraneuronally after uptake of tyrosine. Note that hypofunction of the membrane norepinephrine transporter, responsible for neuronal uptake of catecholamines via the uptake-1 process, should result in augmented responses of plasma norepinephrine levels and attenuated responses of plasma DHPG levels during sympathetic stimulation. MAO = monoamine oxidase.
Thick lines represent increased activity, thin lines represent normal activity, and dashed lines represent decreased activity.
During a panic attack, the amplitude of bursts of sympathetic nerve firing recorded by microneurography increases markedly.
For every affection of the mind that is attended with either pain or pleasure, hope or fear, is the cause of an agitation whose influence extends to the heart, and there induces change from the natural constitution, in the temperature, the pulse and the rest, which impairing all nutrition in its source and abating the powers at large, it is no wonder that various forms of incurable disease in the extremities and in the trunk are the consequence, inasmuch as in such circumstances the whole body labours under the effects of vitiated nutrition and a want of native heat.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Goldstein DS, Robertson D, Esler M, Straus SE, Eisenhofer G. Dysautonomias: Clinical Disorders of the Autonomic Nervous System. Ann Intern Med. ;137:753–763. doi: 10.7326/0003-4819-137-9-200211050-00011
Download citation file:
Published: Ann Intern Med. 2002;137(9):753-763.
Copyright © 2018 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use