The NorthShore Neurological Institute recently opened a new autonomics laboratory with the assistance of Mayo Clinic experts. This emerging area of medicine identifies a rare nervous system disorder that can greatly impact the daily lives of patients. The lab comines the latest technology and a multidisciplinary team to offer patients comprehensive care for complex autonomics disorders.

Alexandru Barboi, MD, Director of the Neuromuscular and Peripheral Neurophysiology Program, answered questions on autonomic disorders and the new laboratory in Connections and continues his Q&A here:

What is the autonomic nervous system?
The autonomic nervous system controls subconscious and visceral functions, such as heart rate, digestion, respiratory rate, salivation, perspiration, swallowing and more. 

What are some common symptoms of autonomic disorders?
Patients may have difficultly standing for longer periods of time, excessive dizziness, lightheadedness, exercise intolerance, gastrointestinal symptoms, bladder and sexual dysfunction and chronic pain. Because symptoms can occur in so many different regions of the body, autonomic disorders are often very challenging to diagnose. 

What does NorthShore’s autonomics lab offer?
Our lab provides state-of-the-art, noninvasive diagnostic testing. It’s one of the most comprehensive in the region. In addition to having sophisticated technology, the lab is staffed with specially trained technicians and a team of experts working together to diagnose and develop individualized treatment plans for adults and children ages seven and older.

Who is generally affected by autonomic disorders? Does it happen more often at a certain age or to someone with an already existing disorder?
Any age group can be affected. Both sexes, but it seems that women are more frequently affected early in life. It can happen in someone who is perfectly healthy but also in people that have an underlying medical condition like diabetes mellitus or Parkinson’s disease.

Do autonomic disorders get worse over time? Is there a range, mild to severe?
Yes they can get worse over time, ranging from mild to severe. They can be completely disabling.

At what point should a patient consider the possibility they might have an autonomic disorder? When should they consider testing?
Any combination of thermoregulation, sweating, cardiac, gut, bladder, sexual dysfunction and chronic neuropathic pain should be considered for an autonomic disorder. Testing always helps define the diagnosis, aids in planning treatment and establishes severity.

What causes an autonomic disorder?
Generally it can be caused by inherited or acquired disorders. The latter can be metabolic, inflammatory, traumatic, autoimmune and degenerative.

What sparked your interest in such a unique field?
My background in internal medicine and neurology and the interplay between both fields. 

What do you find most challenging about your work?
The most challenging part is understanding how an autonomic disorder affects each individual and also understanding how this disorder affects their emotional health too. It’s about harnessing the whole person to actively manage their condition.

What do you find most rewarding?
Definitely seeing patients improve, when they experience a return to having the “best day in my life that I can possibly have.”  As a doctor, when you see that moment in a patient, you never, never give up.