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So I got some testing back. QSART showed small fiber neuropathy and my response to Valsalva maneuver showed "increased central parasympathetic response". I have no idea what this means and honestly my neurologist doesn't either. Can someone offer me guidance as he's willing to collaborate with me and figure this out even though he isn't familiar with autonomic dysfunction. 

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Hi @TorturedSoul - I found these articles that might be helpful for you and your doctor. I think the third paragraph in the "Cardiovascular Reflexes" section will be the most helpful when you are reading through the first link. Good Luck! 

Link 1: https://www.ncbi.nlm.nih.gov/books/NBK402/

Link 2: https://www.vumc.org/adc/38918

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I read this: 'The parasympathetic nervous system is responsible for the body's rest and digestion response when the body is relaxed, resting, or feeding. It basically undoes the work of sympathetic division after a stressful situation. The parasympathetic nervous system decreases respiration and heart rate and increases digestion.' I guess it means it is reacting more?

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15 hours ago, TorturedSoul said:

Thank you!! Still confused about what excessive parasympathetic response actually means. I tried to research it and I read the article you posted but till confused. I have a lot to sort through. Thank you again 

The parasympathetic and sympathetic aspects of the autonomic nervous system each regulate different functions. We get problems when one tries to take over in a situation it is not supposed to control. My parasympathetic system dominates when the sympathetic should dominate. For me this results in orthostatic intolerance. I did well with norepinephrine reuptake inhibitors that increase sympathetic response. But we are all different and it looks like your neurologist has some homework to do. Perhaps he would be willing to do a consult with an autonomic specialist to get more understanding of your test results.

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1 hour ago, TorturedSoul said:

Thank You everyone. @Sushihe did say that the sympathetic acted appropriately to the Valsalva (it increased) but that the parasympathetic increased as well which it shouldn't have. So would an SNRI still be appropriate? 

As I remember, my valsalva test was about the only normal part of my autonomic testing. It was in all the other parts of testing that the parasympathetic was too strong. Whether an SNRI would be appropriate for an individual depends on assessing a whole array of autonomic tests—so your doc needs to do some more investigation if the valsalva was the only test he did. Hope this gets figured out.

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