Pure autonomic failure (PAF) is a medical condition characterized by the impairment or failure of the autonomic nervous system (ANS) without any underlying neurological or systemic diseases. The autonomic nervous system controls involuntary bodily functions such as blood pressure regulation, heart rate, body temperature, digestion, and bladder control.
In PAF, the ANS fails to properly regulate these functions, leading to a range of symptoms. Individuals with PAF commonly experience orthostatic hypotension, which is a sudden drop in blood pressure upon standing, causing dizziness or fainting. They may also exhibit inadequate sweating and dry skin due to impaired regulation of body temperature. Other symptoms may include urinary problems, impotence, constipation, and gastrointestinal difficulties.
The exact cause of PAF is still unknown, but it is believed to be related to the degeneration of the neurons in the autonomic ganglia, which are responsible for transmitting signals between the brain and the body's organs. PAF primarily affects older adults, and the condition can worsen over time.
Although PAF does not have a cure, management of its symptoms is possible. Treatment primarily focuses on improving orthostatic hypotension and maintaining blood pressure through lifestyle modifications such as increasing fluid and salt intake, wearing compression stockings, and avoiding triggers like hot temperatures and prolonged standing. Medications like fludrocortisone, midodrine, and droxidopa may also be prescribed to address low blood pressure. Regular monitoring and care from a healthcare provider familiar with autonomic disorders is crucial for individuals with PAF.
