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Bhagwan T. Shahani, MD, PhD; Timothy J. Day, MD; Didier Cros, MD; Nofal Khalil, MD; Christopher S. Kneebone, MD

Arch Neurol. 1990;47(6):659-664.

Abstract
• The diagnostic value of two simple tests of autonomic function, the RR interval variation and the sympathetic skin response, was evaluated relative to symptoms of dysautonomia in 53 patients with peripheral neuropathy. Of 22 patients with peripheral neuropathy and clinical dysautonomia, 15 showed abnormal results on both tests, and 7 had abnormal results on one test only. In none of the patients with dysautonomia were both tests' results normal. Conversely, all 15 patients with abnormal results of both sympathetic skin response and RR interval variation had symptoms of dysautonomia, while 7 of 15 patients with abnormalities limited to one test had such symptoms. No patient with normal results on both tests had clinical dysautonomia. These data indicate that RR interval variation and sympathetic skin response, both of which can easily be performed in the electromyography laboratory, are helpful in combination in the assessment of autonomic function in peripheral neuropathies.

Author Affiliations
From the Clinical Neurophysiology Laboratories and Department of Neurology, Massachusetts General Hospital, Boston.

Footnotes
Accepted for publication September 29, 1989.

Reprint requests to the Clinical Neurophysiology Laboratories, Massachusetts General Hospital, Boston, MA 02114 (Dr Shahani).

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