Understanding and managing autonomic dysfunction in persons with multiple sclerosis.

Introduction Multiple sclerosis (MS) is a chronic demyelinating immune mediated disease of the central nervous system. Autonomic dysfunction (AD) is frequently present in persons with MS (pwMS) and increases with disease duration and progression. Areas covered Cardiovascular, genitourinary and sudomotor autonomic dysfunction in pwMS are reviewed and managing of these disorders is addressed. Expert opinion AD in pwMS can manifest with a myriad of symptoms including cardiovascular, urogenital and sweating disorders. These symptoms can significantly impact the quality of life of pwMS with poor tolerance of upright position, difficulties in sexual function and low endurance of physical activity especially in warm environments. Health professionals involved in care of pwMS should possess basic knowledge of the function of the autonomic nervous system and be informed of the way disorders of the autonomic function may manifest in pwMS in order to provide the proper care.