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Laboratory Reference for Clinical Neurophysiology$
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Jay A. Liveson and Dong M. Ma

Print publication date: 1999

Print ISBN-13: 9780195129243

Published to Oxford Scholarship Online: March 2012

DOI: 10.1093/acprof:oso/9780195129243.001.0001

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Autonomic Nervous System Studies

Autonomic Nervous System Studies

(p.395) Chapter 21 Autonomic Nervous System Studies
Laboratory Reference for Clinical Neurophysiology

Jay A. Liveson

Dong M. Ma

Oxford University Press

Autonomic function can be tested by its influence on vascular and cardiac function. Thus, the variation of the R-R interval during electrocardiography can be used or changes in blood pressure. The pupillary reflex also reflects parasympathetic function and can be quantitated. Only recently was the technique of sympathetic skin response testing designed specifically so that it could be performed with standard equipment in a clinical electrophysiologic laboratory setting. Microneuronography provides a more direct method to measure function of the autonomic nerve fibers. This entails inserting a fine metal microelectrode into a nerve, and maintaining it in situ while various maneuvers of the autonomic function are performed. Latencies of sympathetic reflexes and conduction velocities can be elicited using this methodology. Routine use of the procedures of microneuronography is impractical. It is invasive, requires special training and practice, and does not permit adequate sampling to be useful in a clinical diagnostic setting.

Keywords:   autonomic function, R-R interval, electrocardiography, pupillary reflex, sympathetic reflexes, conduction velocities, microneuronography

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