Hebson Camden L, McConnell Michael E, Hannon David W
Division of Pediatric Cardiology, Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama.
Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
Congenit Heart Dis. 2019 Mar;14(2):156-161. doi: 10.1111/chd.12720. Epub 2018 Nov 28.
Dysautonomia is an increasingly recognized yet still poorly understood disease within the field of pediatrics. Symptoms, including dizziness, headaches, fatigue, joint pain, anxiety, and intolerance of heat or cold, are often significant and difficult to sort, especially in terms of their relation to each other. This often leads to referral to multiple subspecialists, who then proceed to treat seemingly familiar symptoms in kind. In the authors' experience, this leads to more frustration on the part of the patients and their physicians when symptom improvement does not follow (or can even worsen). On the other hand, by understanding the pathophysiology, treatment success is possible by directing therapies toward the root causes and just as importantly, enlisting the patient in a daily treatment plan. In the text that follows, we hope to convey these viewpoints by highlighting an involved case, discussing the pathophysiology, outlining the usual evaluation, and finally describing our approach to treatment.
自主神经功能障碍是儿科学领域中一种日益受到认可但仍了解不足的疾病。其症状包括头晕、头痛、疲劳、关节疼痛、焦虑以及对热或冷不耐受，这些症状往往很严重且难以梳理清楚，尤其是在它们彼此之间的关系方面。这常常导致患者被转诊至多个专科医生处，而后这些专科医生会针对看似熟悉的症状进行相应治疗。根据作者的经验，当症状没有改善（甚至可能恶化）时，这会让患者及其医生更加沮丧。另一方面，通过了解病理生理学，针对根本原因进行治疗并同样重要的是，让患者参与日常治疗计划，治疗才有可能取得成功。在接下来的文本中，我们希望通过突出一个复杂病例、讨论病理生理学、概述常规评估，最后描述我们的治疗方法来传达这些观点。
