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Pure Autonomic Failure (PAF)
What is Pure Autonomic Failure (PAF)?
Pure autonomic failure (PAF) is a peripheral degenerative disorder of the autonomic nervous system.
Symptoms include:
- In men, a common feature is impotence (inability to have or maintain an erection).
- Orthostatic hypotension, (fall in blood pressure with standing). Orthostatic hypotension may be described as unsteadiness, dizziness, or faintness upon standing. It is worse in the morning, after meals or exercise, or in hot weather. The orthostatic hypotension may also be accompanied by supine hypertension (increased blood pressure while lying down)
- Pain in the neck or back of the head, which is relieved by lying down
- Loss of ability to sweat as much as the body did in the past
- Changes in urination including nocturia (the need to urinate during the night), urinary hesitancy (difficulty starting or maintaining a urinary stream), urgency, dribbling, and occasional incontinence
Who gets PAF?
PAF is most frequently seen in men, in middle to late life.
What causes PAF?
The cause of PAF is not completely known.
How is PAF diagnosed?
In addition to asking detailed questions about the patient’s health, the physician will conduct a physical examination, which will include checking blood pressure and heart rate while the patient is sitting, standing and after one minute of being upright.
What is the treatment for PAF?
PAF is considered a generally mild condition. Treatments for PAF focus on managing symptoms:
- Medication options focus on raising blood pressure (vasopressor agents).
- Non-drug treatment options include squatting, abdominal compression, bending forward and using compression stockings.
- To maintain upright posture, some patients find that crossing their legs helps.
- Drinking water may help to temporarily raise blood pressure
