Table 10.

Autonomic dysfunction [106,107,110].

System	Examples of dysfunction	Potential evaluation and management
Genital-urinary system	Urinary retention Urinary incontinence Nocturia	Evaluation by urology Management of urinary retention by bladder training, catheterization, and/or medications Routine assessment for urinary tract infections
Gastrointestinal system	Feeding difficulties Dysphagia Esophageal dys-motility Delayed gastric emptying Recurrent abdominal pain Intestinal dys-motility Incontinence or constipation	Speech/occupational therapy evaluation of feeding Assessment of nutritional status Assessment for aspiration risk Dietary management: optimize hydration and dietary fiber for constipation Medical management (e.g. stool softeners and laxatives) for constipation
Cardiac and vascular systems	Arrhythmias Tachycardia Hypertension Postural hypotension Acrocyanosis	Evaluation by cardiology Optimization of environmental factors for acrocyanosis Optimization of hydration and salt intake for postural hypotension
Sudomotor function	Temperature regulation (Hyperthermia or Hypothermia) Flushing Sweating issues	Optimization of environmental factors
Ophthalmology	Alacrima Pupillary changes Ptosis	Evaluation by ophthalmology Eye lubrication or eye patching at night to prevent cornea abrasions
Pulmonary	Apneas Disordered breathing Respiratory insufficiency	Evaluation by pulmonology Consider sleep study for diagnosis
Neurology	Pain Sleep cycle dys-regulation Spasticity Dystonia Seizures Irritability	Pain management medications Sleep management interventions