Acute dysautonomia may cause transient oesophageal aperistalsis mimicking achalasia

Objective: Acute dysautonomia may cause long-lasting gastrointestinal symptoms but severe dysphagia has not been reported as yet. Design: Single patient case report. Setting: Gastrointestinal section of a university hospital. Patient: A 38-year-old man presented with recent onset of dysphagia, blurred vision and dry eyes, mouth and skin following a virus-like infection. Manometric findings were consistent with early achalasia, whereas autonomic nerve tests showed abnormal parasympathetic function. Intervention: Follow-up of oesophageal and autonomic system function tests. Outcome: Complete recovery within a few months. Conclusions: Severe oesophageal dysfunction can be caused by a selective cholinergic dysautonomia probably related to viral infection. In such cases, oesophageal derangement may show a rapid spontaneous resolution. © Current Science Ltd.