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. 2021 Apr 8;116(4):814–835. [Article in Portuguese] doi: 10.36660/abc.20200420

Table 4. Survey of Autonomic Symptoms (SAS) questionnaire to diagnose the involvement of different organs and systems in dysautonomia.

Symptoms/Health Problem Have you had any of these symptoms in the last 6 months? 1- Yes; 2- No How severe is this symptom? Scale of 1 to 5 (used if symptoms are present)
1-Darkened vision? 1 or 2 1 – 5
2-Dry mouth or dry eyes?
3-Pallor or cyanosis?
4-Feeling cold in some regions of the body?
5-Reduced feet sweating compared to the rest of the body?
6-Reduced or absent feet sweating after exercising or in hot weather?
7-Increased hand sweating compared to the rest of the body?
8-Nausea, vomiting or gas after light meals?
9-Diarrhea (>3 bowel movements per day)?
10-Persistent constipation?
11-Loss of urine?
12-Erection issues?

Source: Adapted.61 The presence of 3 or more symptoms resulted in 95% sensitivity and 65% specificity, while the presence of 7 or more points determined 60% sensitivity and 90% specificity. Gastrointestinal symptoms were less correlated with other indexes.