Autonomic Testing Laboratory

St. Mary's Medical Center is the only hospital in East Tennessee to offer diagnostic physiological examinations in the Autonomic Testing Laboratory.

Symptoms of autonomic nervous system disease include pain, numbness, tingling, dizziness, lightheadedness, near fainting, fainting, nausea and palpitations or changes in the heart rate.

All the tests are noninvasive and take three to four hours.

Disorders tested:

• Complex regional pain syndrome
• Small fiber peripheral neuropathy
• Generalized autonomic involvement
• Syncopal and presyncopal symptoms related to:
  
  • Vasovagal syncope
  • Postural orthostatic tachycardia syndrome
  • Orthostatic intolerance
  • Grade III orthostatic hypotension
  • Grade IV orthostatic hypotension
  • Delayed orthostatic hypotension
  • Orthostatic hypertension
  • Supine hypertension - orthostatic hypotension
  • Cerebral syncope - decreased intracranial velocity without peripheral hypotension

Tests performed:

• Infrared pyrometry
• Resting sweat output
• Quantitative sudomotor axon reflex
• Heart-rate-response to deep breathing
• Valsalva ratio
• Mean beat-to-beat blood pressure changes during the Valsalva maneuver
• Head up tilt: beat-to-beat blood pressure and heart rate
• Continuous middle cerebral artery TCD monitoring with microemboli detection

Purposes of the tests:

• Detect the presence of an autonomic disorder.
• Quantify the severity of the abnormality or disorder.
• Determine the distribution of the disorder. (Does it involve the heart, brain and extremities?)
• Pinpoint the main site of the abnormality.
• Grade the degree of autonomic failure if present.

Click here for an article in the March 2006 issue of East Tennessee Medical News on the St. Mary's Autonomic Testing Laboratory.