What We Offer You for Autonomic Disorders Care
- World-class expertise in treating all types of autonomic disorders. Go to Conditions Treated
- Advanced treatment options, including medications and lifestyle modifications. Go to Treatments
- Clinical trials that provide access to novel treatment approaches. Go to Clinical Trials
- A team of specialists working in close coordination on a customized care plan to meet your physical, emotional, and spiritual needs. Go to Your Care Team
- Comprehensive support services including educational workshops, fitness classes, and support groups to restore your high quality of life. Go to Support Services
- Easy access to dedicated nurse coordinators who partner with you and your family to guide you through each step of your care. Go to Connecting to Care
Your autonomic nervous system controls functions in your body that take place without conscious control, such as bladder function, blood pressure, body temperature, digestion, heart rate, sexual function, and sweating.
At Stanford Health Care’s Autonomic Disorders Program, our experts provide complete diagnosis, treatment, and support for conditions associated with the autonomic nervous system. We offer all of the specialists and expertise you need in one hospital to manage your full range of care needs and lifelong continuity of care.
Our experienced team diagnoses and treats autonomic disorders, including:
Amyloidosis occurs when proteins (amyloids) build up abnormally in various organs in your body.
Autoimmune autonomic ganglionopathy happens when your immune system attacks and damages your autonomic nervous system.
Neuromuscular conditions affect the way your nerves interact with your muscles. The following neuromuscular conditions impact your autonomic nervous system, causing problems with controlling blood pressure, heart rate, secretion, sweating, digestion, and other body functions:
- Acquired neuromyotonia (Isaacs’ syndrome), when your nerves fire too much, resulting in muscle cramps, stiffness, and twitching
- Guillain-Barré syndrome, when your immune system attacks your nerves, causing numbness, pain, and weakness in your hands, feet, arms, and legs
- Lambert-Eaton myasthenic syndrome (LEMS), when your immune system attacks your muscle tissue, causing muscle weakness
- Limbic encephalitis, when limbic areas of your brain (amygdala and hippocampus) become inflamed, causing confusion, memory loss, seizures, and sleep disturbances
- Morvan syndrome, when a rare neurological disorder affects the brain (encephalopathy), causing muscle cramps, stiffness, and twitches (peripheral nerve hyperexcitability) and nerve damage (autonomic neuropathy)
- Faciobrachial dystonic seizure, when short, frequent seizures mainly affect your arms and face
Autonomic dysfunction/failure (dysautonomia) occurs when your autonomic nervous system is not functioning properly, affecting heart rate and blood pressure, digestion, temperature control, sweating, urination, and sexual function.
Autonomic neuropathy results from damage to nerves that help with organ and organ system functioning.
This nerve disorder is a complication of diabetes that affects involuntary body functions, including heart rate, blood pressure, perspiration, and digestion.
These rare inherited conditions mainly affect fibers of the nerves outside your brain and spinal cord (peripheral nerves). Symptoms include insensitivity to pain, sweating problems, and, sometimes, autonomic failure. Examples of HSAN include familial dysautonomia (Riley-Day syndrome) and congenital insensitivity to pain with anhidrosis (CIPA).
This neurological disorder causes a pupil larger than normal in one eye, which constricts more slowly in bright light.
This rare disorder occurs when certain nerves that travel from your brain to your eyes and face become damaged. Horner’s syndrome usually affects only one side of the face.
Lewy body dementia with orthostatic hypotension happens when proteins (Lewy bodies) build up in your brain. This condition shares characteristics with both Alzheimer's disease and Parkinson's disease.
Multiple system atrophy (MSA) includes symptoms that affect both your autonomic nervous system, such as blood pressure and bladder control, and your ability to move.
Orthostatic hypotension (postural hypotension) is a form of low blood pressure that happens when you stand up from sitting or lying down. This condition causes dizziness or fainting.
Orthostatic intolerance means that you develop symptoms such as lightheadedness, dizziness, or fainting when you stand upright. These symptoms usually go away when you sit back down again.
This complication of Parkinson's disease causes the autonomic nervous system to not function properly.
These nervous system syndromes may occur when cancer-fighting agents of your immune system attack nerve or muscle cells. Paraneoplastic autonomic syndromes are commonly associated with breast cancer, lung cancer, and ovarian cancer.
These disorders occur when your autonomic nervous system is not functioning properly as a result of infection.
Postural orthostatic tachycardia syndrome (POTS) causes your heart rate to raise significantly in response to changing position from lying down to standing, or from sitting to standing.
Pure autonomic failure causes progressive symptoms of autonomic failure, such as difficulty with urination, dizziness or lightheadedness when standing, fainting (syncope), impotence, and sweating.
Autonomic disorders can cause blood pressure that remains high despite treatment (refractory hypertension) or blood pressure that constantly changes between normal and high (labile hypertension). This can include changes in blood pressure with periods of very high blood pressure (baroreflex failure) or high blood pressure when lying down (neurogenic supine hypertension).
Small fiber neuropathy is a painful type of nerve damage (neuropathy) that causes severe sharp or burning pain in your hands or feet. This condition can be difficult to detect or diagnose.
This progressive neurodegenerative disorder is a type of multiple system atrophy (MSA). It is caused by a disruption in the connection between two areas of your brain involved in movement, the striatum and the substantia nigra. This disruption leads to symptoms similar to Parkinson’s disease, like tremors and a lack of balance.
Sweat disorders include lack of sweating (anhidrosis), excessive sweating (hyperhidrosis), and inflammation of sweat glands (hidradenitis).
This common cause of fainting can occur when your body overreacts to certain triggers, such as the sight of blood or extreme emotional distress. Vasovagal syncope leads to a sudden drop in heart rate and blood pressure.
Stanford Health Care Autonomic Disorders Program doctors are renowned for their highly specialized expertise and experience in treating autonomic disorders, a rare specialty. Only about 150 doctors worldwide have the expertise level needed to diagnose and treat autonomic disorders.
INNOVATION HIGHLIGHTS
- We’re the only hospital in California with a comprehensive autonomic testing laboratory.
- Our expert diagnosticians have experience with challenging diagnoses and rare conditions, including those affecting multiple systems of the body.
- We provide same-day autonomic testing and consultation for out-of-state patients.
- We bring together specialists across many disciplines for seamless, coordinated care.
- We’ve partnered with the Stanford Post-Acute COVID Syndrome (PACS) multidisciplinary clinic to help treat patients with long COVID.
Autonomic testing measures how your autonomic nervous system reacts to stimuli to determine which portions of it are and are not functioning as they should. The Autonomic Testing Laboratory at Stanford Health Care is one of only a few comprehensive autonomic testing laboratories on the West Coast.
During autonomic testing, you lie on a long, flat examination table with a foot board and an electrocardiogram (EKG). Your doctor places respiration monitors on your torso. We put a blood pressure monitor on your finger that squeezes and releases to take a continuous reading for the duration of the test. These testing procedures provide information about your autonomic nervous system, including what is working well and what is not working well.
This autonomic test measures your heart rate and blood pressure as you change positions. The table you are lying on is tilted slowly to a semi-upright position of 70 degrees to see how your body responds.
We will ask you to breathe in and out for one minute as we record your blood pressure, chest expansion, and heart rate.
QSART measures your sweating ability through your autonomic nerves using a unique device called a sudorometer. We see how your nerves and sweat glands respond to a painless electrical current passing through your arms, legs, and feet.
TST measures your temperature regulation and sweating ability in a specialized room with controlled temperature, humidity, and air flow capabilities. Stanford Health Care has the only lab on the West Coast with a first-of-its-kind, custom-built TST room.
We will ask you to breathe out forcefully through a mouthpiece, with your nose pinched shut, to look for changes in your blood pressure and heart rate.
If you have problems with digestion, we may suggest gastric-emptying tests to see how fast food leaves your stomach or colonic tests to see how fast food leaves your body.
If you have bladder or urinary symptoms, we can look at your bladder and urinary tract functions with tests that look at how your lower urinary tract works (urodynamic tests), urine tests (urinalysis), or ultrasound.
Treatment Options
We first aim to treat your underlying condition and to help you to manage your symptoms. We customize your plan based on your condition, needs, and health goals. Treatments you receive may include:
In addition to medical treatment, our doctors may recommend changes to your diet and lifestyle to help you control your symptoms.
Diet modifications can be particularly helpful if you have orthostatic hypotension. Our dietitians will work with you on a personalized plan to increase fiber, fluid, or salt intake, if needed. If you have autonomic disorders related to diabetes, we’ll help you control your blood sugar to prevent further nerve damage.
Your care team also supports you in making other lifestyle changes that can help reduce your symptoms. Depending on your condition, these changes may include:
- Raising the head of your bed to lower blood pressure at night
- Following an exercise regimen appropriate for your condition
- Using a walking device to prevent falls
- Wearing compression stockings or a waist binder to help with blood flow
Depending on your condition and symptoms, we may recommend medications to:
- Allow you to empty your bladder or decrease an overactive bladder
- Decrease or improve sweating
- Help with digestive problems
- Improve sexual symptoms, such as erectile dysfunction or vaginal dryness
- Manage your blood pressure
- Reduce nerve pain
- Regulate your heart rate
- Treat Parkinson’s disease symptoms
Care for autonomic disorders goes beyond medical treatments. We encircle you and your family with supportive services to help treat your mind, body, and soul.
Innovation Through Clinical Research
Stanford Health Care Autonomic Disorders Program actively participates in groundbreaking research and clinical trials to evaluate new and better ways to diagnose, treat, and manage autonomic nervous system disorders. Participating in a trial may give you access to experimental therapies that are not available otherwise.
Why I Became a Neurologist
Safwan Jaradeh, MD shares how his father and uncle inspired him to become a doctor, why he was drawn to neurology in particular, and why treating autonomic disorders is significant to him.
Autonomic Disorder Diagnosis and Treatment: A Patient’s Story
Patient Marc Laderriere shares how small, unexplained changes in his heat tolerance and energy led him to a referral to neurologist Dr. Safwan Jaradeh, an unexpected diagnosis, and a promising treatment plan.
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
Open trials refer to studies that are currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
Your Circle of Care
A diagnosis of an autonomic condition—and the changes it may bring—can be unsettling. We offer you and your caregivers the personalized support you need at every step. Your team listens to you and develops a plan for your situation. And you’ll work with the same team from diagnosis throughout treatment, so we can get to know you and your needs.
Each person’s experience is unique, which is why we provide personalized care. Our team tailors treatment and supportive services to meet your individual needs.
Your Doctors
Neurologist
A neurologist is a medical doctor with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system, including those affecting the autonomic nervous system.
View All {0} Neurologists »Advanced Practice Provider
Our health care providers work with your neurologist to help with diagnosis and treatment. Advanced practice providers (APPs) may recommend medications, lifestyle changes, and services such as genetic counseling. An APP can be a nurse practitioner (NP), physician’s assistant (PA), or clinical nurse specialist (CNS).
View All {0} Advanced Practice Provider Doctors »Extended Care Team
Nurses and Nurse Coordinators (RNs)
Multidisciplinary care coordinators are registered nurses who provide one-on-one support throughout your care journey. They help you navigate from your first contact with us to follow-up care, assessing your needs, answering your questions, making referrals, coordinating appointments, and providing education.
View All {0} Medical Acupuncturists »Laboratory Technicians and Technologists
Laboratory technicians and technologists work with your neurologist to conduct autonomic disorders testing.
View All {0} Medical Acupuncturists »Care Coordinators
Care coordinators provide you with information and assistance before and during your appointment.
- Medical Assistant: Medical assistants work with our team to help provide care. They may prepare you for an examination, assist your doctor, or take your vital signs before your appointment.
- Patient Care Coordinator: Our patient care coordinators help you with scheduling appointments and accessing your lab results. They are your first line of contact before you see your provider and will guide you during your autonomic disorder care.
- Patient Access Representative: Patient access representatives can answer your questions about health insurance coverage, help you apply for health insurance, and refer you to our financial counselors.
Research Coordinators
Doctors at Stanford Health Care participate in research efforts to advance the understanding of autonomic disorders and their treatment. Research coordinators help screen candidates for possible participation in clinical research trials.
View All {0} Medical Acupuncturists »Neuro Care Services
Your wellness is our top priority. As part of your care, we design a wellness plan to support you and your family before, during, and after treatment.
We offer a wide array of support services to help you to feel your best. Contact our Neuro Care Services for your personal support plan.
We make access to care as simple as possible. We anticipate what you need and provide support when you need it. Our network of locations puts our services within your reach. User-friendly digital health tools help you stay connected with your care team. We accept most insurance plans and offer discounted transportation, short-stay options, and international travel and translation services. We help make sense of the details, so you can make decisions that are right for you.
At the Stanford Health Care Autonomic Disorders Program, we make accessing care easy and convenient. We make every effort to coordinate your appointments so that you can see multiple providers, as needed, during a single visit.
For Referring Physicians
PHYSICIAN HELPLINE
Phone: 1-866-742-4811
Fax: 650-320-9443
Monday – Friday, 8 a.m. – 5 p.m.
Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff. For help with all referral needs and questions, visit Referring Physicians.
Email or fax an autonomic disorders program referral form with supporting documentation to ReferralCenter@stanfordhealthcare.org or 650-320-9443.
