Diseases of the autonomic nervous system. Autonomic crises requiring emergency medical care

During the period of large-scale military operations in Ukraine, constant shelling of the country’s territory and residential areas, the deaths of military personnel and civilians, including the elderly and children, there have been widespread not only physical injuries but also multisystem disorders affecting mental health, various organs, and body systems, manifesting as headaches, unstable blood pressure, fatigue, irritability, anxiety, sleep disturbances, and dizziness. There may be disturbances in thermoregulation, psychogenic instability, and cognitive impairments. The course of these conditions may be persistent, but may also manifest as autonomic crises. Autonomic crises (autonomic paroxysms or panic attacks) occur in connection with the intensity of the psychoemotional component (fear, panic, anxiety). They are classified as sympathetic (sympathoadrenal crises) against a background of a sharp rise in blood pressure, parasympathetic crises, which occur against a background of a drop in blood pressure, and mixed crises. In cases of severe psychoemotional disorders, they are classified as panic attacks. The literature also distinguishes between hyperventilation (respiratory) crises and gastrointestinal crises. Our goal is to highlight the majority of autonomic crises (paroxysms), perform a differential diagnosis, and determine the appropriate emergency medical care in accordance with current guidelines.