title: [Two years' experience in a specific autonomic nervous system service].
abstract: BACKGROUND
  Despite the high incidence and prevalence of pathologies affecting the autonomic nervous system (ANS), this part of neurology has received very little specific attention in clinical care in our country.
  
  
  OBJECTIVE
  To present the experience we have gained over a two-year period in an ANS-specific service.
  
  
  METHODS
  Our patients were referred to the ANS service by other colleagues, most of whom were neurologists, between April 2006 and April 2008, after proposing a set of eligibility and exclusion criteria. Clinical history, examination and general analysis were performed for all patients. The following tests were also carried out on an individualised basis: Ewing-Clarke test, the Spanish version of the autonomic symptom profile test, tilt table test, holter heart monitor, urodynamic study and reflex sympathetic test, among other complementary studies.
  
  
  RESULTS
  Thirty-four first visits and 62 successive visits were registered. The most frequent diagnoses were neurologically mediated syncopes and diabetic autonomic neuropathies, but other less prevalent conditions were also diagnosed. The most cost-effective complementary tests were the Ewing-Clarke test and the autonomic symptom profile test. Apart from benzodiazepines, the most commonly prescribed pharmacological treatments were paroxetine and pyridostigmine.
  
  
  CONCLUSIONS
  As expected, neurologically mediated syncopes and diabetic neuropathies with an autonomic component are the most frequent pathologies in an ANS service. Nevertheless, their diagnosis and individualised treatment, together with that of other less prevalent autonomic pathologies, may require specific attention. To our knowledge, this is the first service of its kind in our country.
authors.affiliation: Servicio de Neurología, Hospital General Universitario de Alicante, Alicante, Spain. monge_jos@gva.es
authors.forename: J A
authors.initials: JA
authors.lastname: Monge-Argilés
authors.forename: A
authors.initials: A
authors.lastname: Fríes-Ramos
authors.forename: S
authors.initials: S
authors.lastname: Martí-Martínez
authors.forename: C
authors.initials: C
authors.lastname: Leiva-Santana
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000502:physiology / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology* / Q000628:therapy; D003955:Diagnostic Tests, Routine; D006757:Hospital Units / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data; D009462:Neurology