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From the Autonomic Reflex Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN.
Limb dependency activates the venoarteriolar reflex (VAR), resulting in reflex vasoconstriction (RV). Since others have reported the VAR to fail in diabetic neuropathy, we examined the reliability of this test in detecting sympathetic failure in diabetic and other neuropathies. We studied 40 controls, 49 diabetic subjects, and 29 patients with other neuropathies. The mean RV was greater in controls than in diabetics or other neuropathies, but there were marked overlaps among groups. We conclude that the VAR, while impaired in the neuropathies, is of little value as a clinical test and is a poorer test of autonomic function than the quantitative sudomotor axon reflex test or heart rate responses to deep breathing or the Valsalva maneuver.
Address correspondence and reprint requests to Dr. Low, Autonomic Reflex Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Supported in part by giants from NINCDS (RO1 NS2 2352, NS14302, N01 NS7 2302), MDA, Mogg and Mayo Funds. Dr. Low is the recipient of a Jacob Javits Neuroscience Investigator Award.
Received March 21, 1989. Accepted for publication in final form May 12, 1989.
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