[The development of a unit devoted to the study of the autonomous nervous system]

The noninvasive evaluation of the autonomic nervous system (ANS) has been developed in the last decades. The implementation of an specialized unit requires qualified personnel, adequate equipment, location and support. The purpose of the present review is to summarize some theorical and practical aspects of 11 years experience in an ANS Section within a Neurophysiology Department.

During this time we have examined 4,082 patients, using the basic reflex screen in 58% of them with a mean of 100 minutes and 159 Euros per patient. When other types of tests were applied, the time consumed oscillated between 75 and 300 minutes. The patients age ranged from 1 to 91 years, 8% of children among them. From 4,082 patients, the screen was conclusive with some condition related to ANS in 34% of them. The most frequent cause of ANS evaluation was the existence of dizziness, loss of consciousness of unknown origin or syncopal episodes (72%). When patients had at least one spell, sincopal or not, the evaluation was positive in 43%. Patients came from Neurology (67%), Cardiology (8%), Otorhinolaryngology (8%), Endocrinology (7%), and other Departments (10%).

The different disciplines dealing with autonomic functions promote the diverse origin of autonomic evaluation demand. We suggest the convenience of making an accurate estimation of tests, time and cost per patient, to achieve the best unit management.