Acute dysautonomia and polyneuropathy.

A patient experienced an acute dysautonomia manifested by an inability to eat without vomiting, severe constipation, dry mouth, and orthostatic hypotension. One month later, a severe polyneuropathy supervened. The patient subsequently experienced an atonic bladder. Biopsy specimens obtained from the bowel wall disclosed an inflammatory infiltrate within the autonomic nerves consisting of lymphocytes and plasma cells. To our knowledge, this is the first time that inflammatory infiltrates have been demonstrated within the autonomic nerves in a patient with an acute dysautonomia, suggesting a relationship between this illness and the inflammatory polyneuropathies. The patient subsequently had a severe polyneuropathy, lending support to this conclusion.