Assessment of the autonomic nervous system involves checking for the following:
Heart rate changes in response to the Valsalva maneuver
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.)
