neuropathy isn't a single disease, it can be difficult to
diagnose. Often, determining the diagnosis is a matter of ruling
out other causes of the symptoms. Your doctor is likely to take
a medical history, ask for a thorough description of your
symptoms and do a physical exam.
Your doctor also may use a number of tests to
aid in diagnosis. These may include:
Autonomic tests. These
tests measure what happens to your heart rate and blood
pressure and how much you sweat in response to certain
test can measure the electrical impulses of your heart while
you exhale forcibly into an instrument (Valsalva maneuver).
This maneuver increases the pressure in the blood vessels in
Tilt-table test. This
test monitors your blood pressure and heart rate as you lie
flat on a table that is tilted to raise the upper part of
your body. The tilting places stress on your autonomic
nervous system, which regulates your blood pressure and
heart rate. Your doctor can see how you respond to a
situation that's similar to what occurs when you stand up
from lying down. Normally, your body compensates for the
drop in blood pressure that occurs when you stand up by
narrowing your blood vessels and increasing your heart rate.
However, this process may not occur properly in autonomic
Quantitative sudomotor axon
reflex test (QSART).
A small electrical current passes through four capsules
placed on your forearm, foot and leg to activate the nerves
that supply your sweat glands. You'll feel a slight burning
sensation during this testcalled QSART,
Thermoregulatory sweat test.
During this test, you're coated with a powder that changes
color when you sweat. You then enter a chamber with slowly
increasing temperature. It causes your body temperature to
increase 1 to 1.5 degrees Celsius, which makes most people
sweat. Digital photos document the results. Your sweat
pattern may help confirm a diagnosis of autonomic neuropathy
or other causes for decreased sweating.
Ultrasound. For those
with bladder symptoms, high-frequency sound waves create an
image of the bladder and other parts of the urinary tract,
which your doctor can check for abnormalities.
The possible complications of autonomic
neuropathy are many. They may include:
Injuries from falls caused by lowered
blood pressure when you stand
Mental and physical fatigue due to low
Malnutrition and weight loss from
digestive system difficulties
Fluid or electrolyte imbalance from
excessive vomiting or diarrhea, a condition in which your
body loses minerals you need
Relationship problems due to sexual
Urinary tract infections
Cardiovascular complications, such as
irregular heartbeat (arrhythmia)
Kidney failure from bladder problems that
aren't treated properly