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Living with Pure autonomic failure

A nerve condition that causes blood pressure to drop sharply on standing, usually starting in midlife.

Understanding Pure autonomic failure

Pure autonomic failure (PAF) is a disease of the autonomic nervous system, which controls body processes like blood pressure and breathing rate.

It usually affects only the nerves outside the brain and spinal cord. Symptoms begin in midlife, though they can start earlier, and tend to worsen over time. The main symptom is a sudden drop in blood pressure on standing (orthostatic hypotension). Sometimes PAF can lead to other conditions such as Parkinson's disease or multiple system atrophy.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Blood pressure drop when standing
  • Dizziness or lightheadedness
  • Fainting
  • Blurry vision and weakness
  • Bladder problems and constipation
  • Lack of sweating

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include brain and nervous system specialists.

  3. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

  4. Connect with expert centers

    Dysautonomia International may keep lists of experts for this condition.

Care & treatment

Care team
Brain and nervous system specialists (neurologists)
Expert care
Expert lists: Dysautonomia International
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with Dysautonomia International and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
What can help prevent dizziness and fainting when I stand?
Which tests, like tilt table testing, will confirm the diagnosis?
How will I be monitored for other nervous system conditions?

Quick facts

Symptoms usually startAdult and as an Older Adult

GARD says the cause isn't known. Symptoms come from abnormal protein buildups called Lewy bodies in autonomic nerve cells, which reduce norepinephrine and cause low blood pressure.

Neurological

Also known as: autonomic failure; bradbury eggleston syndrome; bradbury-eggleston syndrome; idiopathic orthostatic hypotension; paf; pure dysautonomia

Patient organizations

Source: NIH GARD · Pure autonomic failureGARD ID 10428 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Pure autonomic failure.

Explore the Pure autonomic failure blog

Explore research for Pure autonomic failure

Explore actively recruiting Pure autonomic failure studies with HealthSpark.

HealthSpark

Find actively recruiting studies for Pure autonomic failure with HealthSpark. Share your city to explore research near you.

  • Recruiting studies from ClinicalTrials.gov
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  • Eligibility is confirmed by the study team

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Powered by HealthSpark, our AI chat helper · Study information from ClinicalTrials.gov · Eligibility is confirmed by the study team.

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