Autonomic dysfunctions in multiple sclerosis: Challenges of clinical practice (Review)

Sirbu,Carmen Adella; Mezei,Raluca-Mihaela; Falup‑Pecurariu,Cristian; Bratu,Ovidiu Gabriel; Sirbu,Anca Maria; Ghinescu,Minerva Claudia; Radu,Florentina Ionita

doi:10.3892/etm.2020.9326

Autonomic dysfunctions in multiple sclerosis: Challenges of clinical practice (Review)

Authors:
- Carmen Adella Sirbu
- Raluca-Mihaela Mezei
- Cristian Falup‑Pecurariu
- Ovidiu Gabriel Bratu
- Anca Maria Sirbu
- Minerva Claudia Ghinescu
- Florentina Ionita Radu
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Affiliations: Department of Preclinical Disciplines, Faculty of Medicine, ‘Titu Maiorescu’ University, 031593 Bucharest, Romania, Department of Neurology, Central Military Emergency University Hospital, 010242 Bucharest, Romania, Department of Neurology, County Emergency Clinic Hospital, 500365 Brasov, Romania, Department of Urology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Endocrinology, ‘C. I. Parhon’ National Institute of Endocrinology, 011863 Bucharest, Romania
Published online on: October 14, 2020 https://doi.org/10.3892/etm.2020.9326
Article Number: 196

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Abstract

Multiple sclerosis, demyelinating, inflammatory, degenerative, and chronic disease, raises many challenges in terms of disease management. The autonomic nervous system is affected by neuroinflammation but also contributes to its maintenance and the evolution of the disease. Multiple sclerosis interfering with parasympathetic or sympathetic modulation may influence the immune response. Less attention is paid to autonomic dysfunctions, although they produce a serious impact on the quality of life. In addition to motor disabilities, patients also have non‑motor dysfunctions. Regardless of its clinical forms, patients with multiple sclerosis may have autonomous disturbances such as bladder, sexual, cardiovascular, thermoregulatory, gastrointestinal dysfunction and fatigue. These must be identified based on medical history, clinical symptoms, and specific paraclinical tests. In addition to the multitude of immunomodulatory therapeutic agents that influence the progression of the disease, the therapy of autonomic dysfunctions remains difficult to address. However, their identification and treatment lead to increased quality of patient management and avoid complications of this disease.

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