Clinical Staff
Diseases and Conditions Treated
Basic Research
Other Resources
Contact Us
Clinical Staff
William T. Talman, MD
Dr. Talman's work in autonomic disorders has earned him recognition among the "Best Doctors in America".
Diseases and Conditions Treated in the Autonomic Clinic
Autonomic Disorders
Autonomic Disorders may adversely affect genitourinary function,
gastrointestinal function, sweating, pupillary function, and cardio-vascular function. The Autonomic Clinic focuses on adverse effects on cardiovascular function with particular reference to control of
blood pressure and cardiac rate. The Clinic closely cooperates with
the Department of Urology for genitourinary problems, the Division of Gastroenterology for GI problems, the Department of Dermatology for problems of excess or diminished sweating, the Division of Neuroophthalmology for pupillary dysfunction and the Division of Cardiology as noted below.
Orthostatic Hypotension
Orthostatic hypotension is a condition in which the patient
feels faint, or indeed may faint (pass out or lose consciousness),
upon standing. The condition can result from a number of
diseases (see below) that disturb the autonomic nervous system
and prevent it from properly sensing and responding to a change
in one’s posture, but it also can result from conditions that affect
the heart and cardiovascular system so that it cannot respond
adequately to a postural stress. The Autonomic Clinic focuses
on those diseases that affect the autonomic nervous system but
it has a close working relationship with members of the Division
of Cardiology of the University of Iowa’s Department of Internal
Medicine. Those colleagues extend the state of the art investigations
performed in the Autonomic Clinic to include similar advanced
investigations of the heart and circulatory system.
Some Conditions that Cause Orthostatic Hypotension
- Volume Loss without fluid replacement
- As from prolonged vomiting or diarrhea
- As from excess diuresis
- As from excess sweating
- As from blood loss
- Iatrogenic
- As from diuretics
- As from antihypertensive medications
- As from some antidepressants
- As from L-dopa-like drugs
- Deconditioning
- As from prolonged confinement with illness or injury
- As from medications that interfere with vascular tone
- Diabetic Neuropathy
- Other Axonal Neuropathies
- Primary Autonomic Failure (Bradbury Eggleston Syndrome)
- Multiple System Atrophy (Shy Drager Syndrome)
- Parkinson’s Disease
Basic Research
The Laboratory of Neurobiology investigates mechanisms through
which the central nervous system modulates and controls cardiovascular
function and cerebral blood flow. A particular emphasis is identification of
neurotransmitters that convey signals through synapses in those central
pathways that mediate reflex circulatory control. The lab has been instrumental
in establishing that the excitatory amino acid glutamate is the neurotransmitter
released by baroreceptor nerves in the brain, that the actions of glutamate are
intimately linked with nitric oxide derived from central neurons, that the
baroreflex can modulate cerebral blood flow, and that the influence of baro-
reflexes on cerebral blood flow are mediated by release of nitric oxide from
parasympathetic nerves that innervate cerebral blood vessels.
Other Resources
The Autonomic Clinic closely collaborates with experts in the following
focuses departments to provide a multidisciplinary approach to patients
with disturbed autonomic function:
Contact Information
Appointments: 319-356-2571
FAX: 319-384-6269 (Attn: Dr. Talman)
Address: Department of Neurology
University of Iowa Hospitals and Clinics
200 Hawkins Dr., 2100 RCP
Iowa City, IA 52242
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