Pandysautonomic neuropathy in a 15 year old female

The syndrome of acute pandysautonomia was first reported in 1969, and described as the development of severe sympathetic and parasympathetic autonomic dysfunction with relative or complete preservation of somatic motor/sensory functions. Initial nonspecific symptoms of fatigue, headache, and generalized vague pain are followed by autonomic symptoms including orthostatic hypotension, light-headedness, blurring of vision, abdominal pain, diarrhea, dryness of eyes, cold feet/hands, reduced or accentuated sweating, dysphagia, gastroparesis, and defects in micturition stream and/or volume. A prodrome of febrile or viral illness may precede the onset of illness. The symptoms evolve over a period of a few days or weeks, but may be more gradual. Autonomic neuropathies have been associated with the presence of specific autoantibodies and also may present as feature of an autoimmune-mediated peripheral neuropathy.