Diabetes REF: Harrison's Internal Medicine 17'h edition chapter 370 I. Autonomic disorders with brain involvement A. Associated with multisystem degeneration 1. Multisystem degeneration: autonomic failure clinically prominent Multiple system atrophy (MSA) Parkinson's disease with autonomic failure Diffuse Lewy body disease (some cases) 2. Multisystem degeneration: autonomic failure clinically not usually prominent Parkinson's disease Other extrapyramidal disorders (inherited spinocerebellar atrophies, progressive supranuclear palsy, coicobasal degeneration, Machado-Joseph disease) B. Unassociated with multisystem degeneration 1. Disorders mainly due to cerebral coex involvement Frontal coex lesions causing urinary/bowel incontinence Paial complex seizures 2. Disorders of the limbic and paralimbic circuits Shapiro's syndrome (agenesis of corpus callosum, hyperhidrosis, hypothermia) Autonomic seizures 3. Disorders of the hypothalamus Wernicke-Korsakoff syndrome Diencephalic syndrome Neuroleptic malignant syndrome Serotonin syndrome Fatal familial insomnia Antidiuretic hormone (ADH) syndromes (diabetes insipidus, inappropriate ADH) Disturbances of temperature regulation (hypehermia, hypothermia) Disturbances of sexual function Disturbances of appetite Disturbances of BP/HR and gastric function Horner's syndrome 4. Disorders of the brainstem and cerebellum Posterior fossa tumors Syringobulbia and Arnold-Chiari malformation Disorders of BP control (hypeension, hypotension) Cardiac arrhythmias Central sleep apnea Baroreflex failure Horner's syndrome H. Autonomic disorders with spinal cord involvement Traumatic quadriplegia Syringomyelia Subacute combined degeneration Multiple sclerosis Amyotrophic lateral sclerosis Tetanus Stiff-man syndrome Spinal cord tumors III. Autonomic neuropathies A. Acute/subacute autonomic neuropathies 1. Subacute autoimmune autonomic neuropathy (panautonomic neuropathy, pandysautonomia) Subacute paraneoplastic autonomic neuropathy Guillain-Barre syndrome Botulism Porphyria Drug induced autonomic neuropathies Toxic autonomic neuropathies B. Chronic peripheral autonomic neuropathies 1. Distal small fiber neuropathy 2. Combined sympathetic and parasympathetic failure Amyloid Diabetic autonomic neuropathy Autoimmune autonomic neuropathy (paraneoplastic and idiopathic) Sensory neuronopathy with autonomic failure Familial dysautonomia (Riley-Day syndrome)