2018 Dysautonomia International Conference - Closing Q&A With the Experts

The closing Q&A session from the 2018 Dysautonomia International Conference tackled numerous aspects of dysautonomia and related conditions such as POTS, EDS, and MCAS. Experts discussed the evolving diagnosis criteria published by major cardiovascular societies, the prevalence and treatment of Chiari malformations in patients with hypermobility, and the co-occurrence of migraines and POTS, hinting at neurovascular and central sensitization mechanisms. An emphasis was placed on exploring underlying issues in patients with POTS to avoid misdiagnosis. The panel also addressed the shortage of autonomic specialists and possible strategies, such as fellowship funding to increase training. They highlighted the synergy between poor sleep and dysautonomia symptoms, and discussed safety and efficacy concerns surrounding treatments like IVIG for autoimmune-related POTS, functional neurology in retraining the brain, the role of cannabis for nausea, and the challenges of anesthesia in conditions like EDS. Overall, a conservative approach to new treatments was advised, pending further evidence, while highlighting the importance of comprehensive system reviews to guide management.