How To Assess the Autonomic Nervous System

Assessment of the autonomic nervous system involves checking for the following:

• Postural hypotension

• Heart rate changes in response to the Valsalva maneuver

• Decreased or absent sweating

• Evidence of Horner syndrome (unilateral ptosis, pupillary constriction, facial anhidrosis)

Disturbances of bowel, bladder, sexual, and hypothalamic function should be noted. For example, patients with hypothalamic tumors or other injuries may experience constipation, urinary retention and associated symptoms, amenorrhea, galactorrhea, infertility, decreased libido or alterations of sleep, thirst, and appetite.

(See also Overview of the Autonomic Nervous System.)