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Autonomic Neuropathy within the NOx (Knox) Framework Hypothesis: A Case-Based Reappraisal of Deterministic Neurodegenerative Assumptions
Abstract
Autonomic neuropathy has traditionally been interpreted within clinical neurology as a progressive and frequently irreversible condition, often assumed to phenoconvert into neurodegenerative disease [1-5]. This paper integrates a longitudinal patient case (2020–2026) with a structured review of medical literature to demonstrate that such deterministic interpretations are not consistently supported by evidence [8–10]. Through the NOx (Knox) Framework Hypothesis, autonomic dysfunction dysautonomia is reconceptualised as a system-level regulatory disturbance with multiple potential trajectories, including stabilisation, fluctuation, and partial or complete recovery [3,10].