Autonomic Nervous System Disorders

Your autonomic nervous system is the part of your nervous system that controls involuntary actions, such as the beating of your heart and the widening or narrowing of your blood vessels. When something goes wrong in this system, it can cause serious problems, including:

• Blood pressure problems
• Heart problems
• Trouble with breathing and swallowing
• Erectile dysfunction in men

Autonomic nervous system disorders can occur alone or as the result of another disease, such as Parkinson's disease, alcoholism and diabetes. Problems can affect either part of the system, as in complex regional pain syndromes, or all of the system. Some types are temporary, but many worsen over time. When they affect your breathing or heart function, these disorders can be life-threatening.

Some autonomic nervous system disorders get better when an underlying disease is treated. Often, however, there is no cure. In that case, the goal of treatment is to improve symptoms.

NIH: National Institute of Neurological Disorders and Stroke

Bell's Palsy

Bell's palsy is the most common cause of facial paralysis. It usually affects just one side of the face. Symptoms appear suddenly and are at their worst about 48 hours after they start. They can range from mild to severe and include:

• Twitching
• Weakness
• Paralysis
• Drooping eyelid or corner of mouth
• Drooling
• Dry eye or mouth
• Excessive tearing in the eye
• Impaired ability to taste

Scientists think that a viral infection makes the facial nerve swell or become inflamed. You are most likely to get Bell's palsy if you are pregnant, diabetic or sick with a cold or flu.

Three out of four patients improve without treatment. With or without treatment, most people begin to get better within 2 weeks and recover completely within 3 to 6 months.

NIH: National Institute of Neurological Disorders and Stroke

Blood Clots

What is a blood clot?

A blood clot is a mass of blood that forms when platelets, proteins, and cells in the blood stick together. When you get hurt, your body forms a blood clot to stop the bleeding. After the bleeding stops and healing takes place, your body usually breaks down and removes the blood clot. But sometimes the blood clots form where they shouldn't, your body makes too many blood clots or abnormal blood clots, or the blood clots don't break down like they should. These blood clots can be dangerous and may cause other health problems.

Blood clots can form in, or travel to, the blood vessels in the limbs, lungs, brain, heart, and kidneys. The types of problems blood clots can cause will depend on where they are:

• Deep vein thrombosis (DVT) is a blood clot in a deep vein, usually in the lower leg, thigh, or pelvis. It can block a vein and cause damage to your leg.
• A pulmonary embolism (PE) can happen when a DVT breaks off and travels through the bloodstream to the lungs. A PE, especially if it is large, can damage your lungs and prevent your other organs from getting enough oxygen.
• Cerebral venous sinus thrombosis (CVST) is a rare blood clot in the venous sinuses in your brain. Normally the venous sinuses drain blood from your brain. CVST blocks the blood from draining and can cause a hemorrhagic stroke.
• Blood clots in other parts of the body can cause problems such as an ischemic stroke, a heart attack, kidney problems, kidney failure, and pregnancy-related problems.

Who is more likely to develop blood clots?

Certain factors can raise your risk of developing blood clots:

• Atherosclerosis
• Atrial fibrillation
• Being overweight or having obesity
• Cancer and cancer treatments
• Certain genetic disorders
• Certain surgeries
• COVID-19
• Diabetes
• Family history of blood clots
• Overweight and obesity
• Pregnancy and giving birth
• Serious injuries
• Some medicines, including birth control pills
• Smoking
• Staying in one position for a long time, such as being in the hospital or taking a long car or plane ride

What are the symptoms of blood clots?

The symptoms for blood clots can be different, depending on where the blood clot is:

• In the abdomen: Abdominal pain, nausea and vomiting
• In an arm or leg: Sudden or gradual pain, swelling, tenderness, and warmth
• In the lungs: Shortness of breath, pain with deep breathing, rapid breathing, and increased heart rate
• In the brain: Trouble speaking, vision problems, seizures, weakness on one side of the body, and sudden severe headache
• In the heart: Chest pain, sweating, shortness of breath, and pain in the left arm

How are blood clots diagnosed?

To find out if you have one or more blood clots, your health care provider:

• Will do a physical exam.
• Will take your medical history, which includes asking about your symptoms.
• May order blood tests, including a D-dimer test.
• May order imaging tests, such as
  • Ultrasound.
  • X-rays of the veins (venography) or blood vessels (angiography) that are taken after you get an injection of special dye. The dye shows up on the x-ray and allows the provider to see how the blood flows.
  • CT Scan.

What are the treatments for blood clots?

Treatments for blood clots depend on where the blood clot is located and how severe it is. Treatments may include:

• Blood thinners.
• Other medicines, including thrombolytics. Thrombolytics are medicines that dissolve blood clots. They are usually used where the blood clots are severe.
• Surgery and other procedures to remove the blood clots

Can blood clots be prevented?

You may be able to help prevent blood clots by:

• Moving around as soon as possible after having been confined to your bed, such as after surgery, illness, or injury
• Getting up and moving around every few hours when you have to sit for long periods of time, for example if you are on a long flight or car trip
• Wearing compression stockings after surgery or during a long flight
• Regular physical activity
• Not smoking
• Staying at a healthy weight

Some people at high risk may need to take blood thinners to prevent blood clots.

Blood Thinners

What are blood thinners?

Blood thinners are medicines that prevent blood clots from forming. They do not break up clots that you already have. But they can stop those clots from getting bigger. It's important to treat blood clots, because clots in your blood vessels and heart can cause heart attacks, strokes, and blockages.

Who needs blood thinners?

You may need a blood thinner if you have:

• Certain heart or blood vessel diseases
• An abnormal heart rhythm called atrial fibrillation
• A heart valve replacement
• A risk of blood clots after surgery
• Congenital heart defects

What are the different types of blood thinners?

There are different types of blood thinners:

• Anticoagulants, such as heparin or warfarin (also called Coumadin), slow down your body's process of making clots.
• Antiplatelets, such as aspirin and clopidogrel, prevent blood cells called platelets from clumping together to form a clot. Antiplatelets are mainly taken by people who have had a heart attack or stroke.

How can I take blood thinners safely?

When you take a blood thinner, follow the directions carefully. Blood thinners may interact with certain foods, medicines, vitamins, and alcohol. Make sure that your health care provider knows all of the medicines and supplements you are using.

You may need regular blood tests to check how well your blood is clotting. It is important to make sure that you're taking enough medicine to prevent clots, but not so much that it causes bleeding.

What are the side effects of blood thinners?

Bleeding is the most common side effect of blood thinners. They can also cause an upset stomach, nausea, and diarrhea.

Other possible side effects can depend on which type of blood thinner that you are taking.

Call your provider if you have any sign of serious bleeding, such as:

• Menstrual bleeding that is much heavier than normal
• Red or brown urine
• Bowel movements that are red or black
• Bleeding from the gums or nose that does not stop quickly
• Vomit that is brown or bright red
• Coughing up something red
• Severe pain, such as a headache or stomachache
• Unusual bruising
• A cut that does not stop bleeding
• A serious fall or bump on the head
• Dizziness or weakness

Brain Aneurysm

A brain aneurysm is an abnormal bulge or "ballooning" in the wall of an artery in the brain. They are sometimes called berry aneurysms because they are often the size of a small berry. Most brain aneurysms produce no symptoms until they become large, begin to leak blood, or burst.

If a brain aneurysm presses on nerves in your brain, it can cause signs and symptoms. These can include:

• A droopy eyelid
• Double vision or other changes in vision
• Pain above or behind the eye
• A dilated pupil
• Numbness or weakness on one side of the face or body

Treatment depends on the size and location of the aneurysm, whether it is infected, and whether it has burst. If a brain aneurysm bursts, symptoms can include a sudden, severe headache, nausea and vomiting, stiff neck, loss of consciousness, and signs of a stroke. Any of these symptoms requires immediate medical attention.

NIH: National Heart, Lung, and Blood Institute