Bruce H. Knox
Independent Scholar, Auckland, New Zealand
Publications
-
Research Article
Multi-System Secondary Autonomic Dysfunction Recovery: A Three-Hit Injury Model and Six Clinical Flags of Autonomic Network Repair
Author(s): Bruce H. Knox*
Autonomic dysfunction may arise through primary neurodegenerative disease or secondary injury affecting autonomic regulatory networks. Distinguishing between these mechanisms is clinically important because secondary autonomic dysfunction may retain substantial capacity for recovery. This paper integrates a patient-investigator hypothesis describing a three-hit model of severe secondary autonomic dysfunction with a practical framework for recognising recovery. The first hit consisted of Chikungunya virus (CHIKV) infection in 2008, likely producing chronic autonomic vulnerability through small-fibre and autonomic nervous system injury. The second and third hits occurred in October 2021 during a left ventricular outflow tract premature ventricular contraction ablation complicated by ventricular perforation, cardiac tamponade, emergency thoracotomy, and cardiopulmonary bypass repair. Fol.. Read More»