The autonomic nervous system supplies and influences virtually every organ in the body.  Additionally, it is involved in major integrative processes such as control of blood pressure and body temperature. 

The autonomic unit provides a comprehensive national tertiary clinical service (combining both investigation and management) for a wide variety of autonomic disorders. The unit enables people with autonomic symptoms, some of which are multiple and complex, to successfully manage their daily lives. Some examples are:

  • Pure Autonomic Failure
  • Autonomic dysfunction complicating Parkinson’s disease
  • Multiple System Atrophy (MSA)
  • Sweating dysfunction (including hyperhidrosis, compensatory hyperhidrosis and anhidrosis)
  • Holmes-Adie Syndrome, Harlequin’s Syndrome
  • Autonomic dysfunction in spinal cord injury including autonomic dysreflexia
  • Neurally mediated syncope (Vasovagal, carotid sinus hypersensitivity and situational e.g. swallow, micturition syncope)
  • Postural tachycardia syndrome (PoTS)
  • Neurogenic hypertension
  • Autonomic diabetic neuropathy.

There are four laboratories incorporating the latest advances in non-invasive technology and a catecholamine laboratory for the measurement of various autonomic neurotransmitters.

As autonomic dysfunction is a feature of many neurological conditions, there is close and active clinical collaboration with many NHNN departments and disciplines including clinical neurophysiology, clinical neuropsychology, movement disorders, and behavioural psychotherapy. Research affiliations include the Functional Imaging Laboratory at the ION, the ICN, the Department of Medicine at UCL, and the National Amyloidosis Centre at the Royal Free Hospital.

Service management

  • David OKeefe

Other contact information

Clinical lead: Dr Valeria Iodice

Valeria Iodice pic.jpg

Testing/diagnostic queries: 020 3448 3739, 020 3448 3049


Autonomic unit
National Hospital for Neurology and Neurosurgery
2nd Floor 
Queen Mary Wing 
Queen Square 
London WC1N 3BG

Other referral information

GP referrals

GP referrals (on the advice of consultants) must be submitted electronically via NHS e-referrals (formely Choose and Book).

Tertiary Referrals

Referrals from consultants in all specialities from around the country can be submitted by post or fax or email; approximately 50% of our referrals come from outside the home counties.

The Autonomic Unit
Box 87
The National Hospital for Neurology and Neurosurgery
Queen Square

  • Fainting (syncope, posturally induced dizziness) episodes disorders of temperature regulation (including excessive sweating; hyperhidrosis) - these may be a key component of predominantly autonomic diseases such as pure autonomic failure, multiple system atrophy or may be a complication of diseases such as Parkinson's disease, Lewy body disease or amyloidosis.
  • Low blood pressure
  • Orthostatic (postural) hypotension

Other disorders we provide care for include:

  • Acute/subacute dysautonomia
  • Amyloidosis (familial and primary)
  • Anihidrosis
  • Congenital autonomic failure
  • Diabetes mellitus
  • Guillain-Barré syndrome
  • Holmes-Adie syndrome
  • Hyperhidrosis (essential and gustatory)
  • Neurally mediated syncope (vasovagal, micturition, cough, swallow and other situational forms, carotid sinus supersenstivity)
  • Pheochromocytoma
  • Postural tachycardia syndrome (PoTS)
  • Transverse myelitis

Where relevant extended through clinical autonomic nurse specialist.

The autonomic unit shares care with GPs and local consultants.