Autonomic Laboratory
Patient Questions, February 1999
This Web page is designed for the general education of patients and their families.
Disclaimer: The answers provided are the opinion of Dr.
Tom Chelimsky. No patient should make any changes in their care without
first consulting their physician.
Question: Is there any correlation between damage to the hypothalamus damage and autonomic disorders? I had a pituitary apoplexy at age 26 and have had had slowly progressive autonomic failures since. How about adrenal problems?
Dr. Chelimsky: Usually, true pituitary apoplexy involves only the endodrine functions of the pituitary, not the hypothalamic functions. This is because the apoplexy itself is generated by the way in which blood flows to the pituitary: the flow requirement during pregnancy becomes very high due to the large hormonal production, and if something happens to reduce blood flow to the pituitary during that time, most of it will die off rapidly. The same blood flow usually does not go to the hypothalamus, but rather, blood from the hypothalamus goes to the pituitary. If there had been very extensive damage, or as one sometimes sees in cases of head trauma, it is possible for the hypothalamus to have been affected as well. However, this would not be the first thought in such a case, but one should initially consider the possibility of a second separate disorder. Autonomic testing in an autonomic laboratory, especially including "axon reflex" testing of the sweat glands would be very useful to see if the problem is in the peripheral nervous system (not related to the hypothalamus) or in the central nervous system (potentially related to the hypothalamus). A thermoregulatory sweat test would also help a lot in answering the question.
If you have a question, please submit it to Dr. Chelimsky.