Autonomic dysfunction in Wilson's disease - A clinical and electrophysiological study

Salvadeeswaran Meenakshi-Sundaram, Arun B. Taly*, Vikram Kamath, G. R. Arunodaya, Shivaji Rao, H. S. Swamy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

52 Citations (Scopus)


Wilson's disease is known for its protean manifestations; however involvement of the autonomic nervous system has not received much attention. Fifty patients with varying duration and severity of illness were evaluated for autonomic dysfunction clinically and electrophysiologically, using sympathetic skin response (SSR) and RR interval variability (RRIV) on deep breathing. The change in heart rate (ΔHR) was calculated from RRIV. Five patients had at least one autonomic symptom and one asymptomatic patient had significant postural hypotension. Absent SSR and abnormal ΔHR were noted in seven patients each. Overall, 13 patients had electrophysiological dysautonomia and an additional six had clinical dysautonomia. All had normal peripheral conductions and all but one had normal hepatic functions. Dysautonomia was more common among patients with neurological presentation (12/32) than non-neurological (1/18) (p = .012). Dysautonomia, often subclinical is common in Wilson's disease and is probably of central origin. It is more frequent among those with neurological presentation. Sympathetic and parasympathetic functions are equally affected.

Original languageEnglish
Pages (from-to)185-189
Number of pages5
JournalClinical Autonomic Research
Issue number3
Publication statusPublished - 2002
Externally publishedYes


  • Dysautonomia
  • R-R interval variability
  • Sympathetic skin response
  • Wilson's disease

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology


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