Autonomic dysfunction in multiple sclerosis

•Autonomic dysfunction in multiple sclerosis is related to multiple factors.•Autonomic dysfunction is found in 45% to 84% of multiple sclerosis patients.•Multiple sclerosis pathogenesis may be influenced by autonomic dysfunction.

Autonomic dysfunction is a prevalent and significant cause of disability among patients with multiple sclerosis. Autonomic dysfunction in multiple sclerosis is usually explained by lesions within central nervous system regions responsible for autonomic regulation, but novel evidence suggests that other factors may be involved as well. Additionally, the interactions between the autonomic nervous system and the immune system have generated increased interest about the role of autonomic dysfunction in the pathogenesis of multiple sclerosis. In this paper we analyze systematically the most relevant signs and symptoms of autonomic dysfunction in MS, considering separately their potential causes and implications.