Changing symptoms
One day, dizziness or circulatory difficulties dominate; another day, exhaustion, inner restlessness, sleep or digestive difficulties are more prominent.
Autonomic dysregulation & complex symptoms
A functional approach to complex nervous system dysregulation
When circulation, sensory processing, sleep and resilience do not work together reliably, the symptom picture can quickly feel unclear.
In Applied Neurofunction, this overall picture is broken down into specific functions that can be assessed: identify findings, test suitable inputs, integrate them and re-test identically.
Variable symptoms
Symptoms change with demands, day-to-day condition or the situation.
Autonomic dysregulation
Circulation, sleep, temperature or internal activation respond inconsistently.
Intolerance of exertion
Small physical or mental demands may trigger strong or delayed responses.
About the images: The scene images on this page are AI-generated illustrations. They do not show real clients or document actual sessions in the practice.
Ask more than: where is the symptom?
Ask: under which conditions does the function change?
When symptoms do not fit a clear category
When the body responds differently to demands again and again
Complex conditions often involve more than one symptom. More typically, there is a pattern of variable symptoms, fluctuating tolerance of exertion and responses that cannot clearly be assigned to just one organ or structure.
Fluctuating capacity
What was easy yesterday may take considerably more energy today or worsen symptoms. Some responses also appear only after a delay following exertion.
Several systems at once
Circulation, sleep, temperature regulation, digestion, sensory processing, balance or internal activation may all respond unusually at the same time and influence one another.
Symptoms despite normal findings
Medical examinations can investigate important causes, but do not necessarily explain every functional response. Symptoms may therefore remain real and distressing even when individual findings are normal.
A brief explanation of the terms
Vegetative dysregulation, autonomic dysregulation or vegetative dystonia?
Terms such as vegetative dysregulation, autonomic dysregulation or vegetative dystonia are used in different ways. They often refer to symptom patterns in which automatic body functions such as circulation, breathing, digestion, temperature regulation or activation do not adapt consistently to changing demands.
For a functional assessment, the broad term used is therefore less important than the question of under which conditions the system responds inconsistently, which functions change and how reproducible these responses are.
When several systems are involved at once
Which complex conditions does this focus cover?
This area of focus is mainly intended for symptom patterns in which regulation, tolerance of exertion and autonomic responses are inconsistent, or several systems appear to be affected at once.
The diagnosis alone does not determine the approach.
Two people with the same diagnosis may differ considerably in their tolerance of exertion, sensory processing and autonomic regulation.
01
Autonomic and orthostatic symptoms
Dizziness on standing up, palpitations, circulatory instability, temperature difficulties or symptoms during prolonged standing may indicate difficulties with autonomic or orthostatic regulation. This also includes symptom patterns resembling POTS.
02
ME/CFS and pronounced exertion intolerance
In ME/CFS and similar conditions, even small physical or mental demands may trigger significant or delayed deterioration. Tolerance and responses therefore need to be considered with particular care.
03
Long Covid and post-infectious conditions
After infections, symptoms such as exhaustion, brain fog, dizziness, circulatory difficulties, sleep disturbances or changed tolerance of exertion may persist.
04
Neurological and neuroinflammatory relationships
In people with known neurological illnesses or conditions involving neuroinflammation, it may also be useful to consider how consistently the nervous system currently responds to movement, perception and demands.
These terms describe a broad medical context. In practical work, the next questions are
which functions currently respond inconsistently, what changes them and which demands the system can actually process.
Complex conditions rarely follow a straight line
Why these states are often difficult to understand
In complex or post-infectious symptoms, the currently present symptom is not the only important factor. Responses may appear after a delay, depend on current demands or not be fully reflected in a single medical finding.
Responses may be delayed
Not every overload is felt immediately. Exhaustion, brain fog, dizziness or other symptoms may become significantly worse only hours later or the following day.
Conditions change the response
Sleep, heat, previous exertion, mental demands or an infection can influence how well the same activity is processed at a particular time.
A single measurement does not capture the whole course
A stable measurement at rest may miss what only becomes apparent on standing up, under visual demands, after concentrated work or following a delay.
One moment is therefore often not enough.
What also matters is under which conditions a response occurs, how strong it is and how long the system then takes to stabilise again. Particularly in complex conditions, the course over time is therefore more important than considering one symptom in isolation.
Circulation needs to adapt constantly
Autonomic dysregulation during position changes, standing and exertion
Autonomic regulation becomes particularly visible when the body needs to adapt its circulatory and activation responses to a new situation, such as standing up, standing for a long time, heat or physical exertion.
Regulation becomes especially apparent during change.
The body needs to respond continuously to position, temperature and exertion, rather than merely maintain a single resting measurement.
When standing up, heat or exertion challenge the system
Orthostatic symptoms occur particularly when heart rate, vascular tone and circulation need to adapt to changed demands.
Standing up and changing position
Dizziness, light-headedness, palpitations or a sense of instability may appear particularly when moving from lying or sitting to standing.
Standing and heat
Prolonged standing, warm rooms, showering or high outdoor temperatures may place additional demands on circulation and vascular regulation.
Physical and mental exertion
Some people respond to activity immediately; others experience exhaustion, brain fog, dizziness or a significant decline in capacity only later.
The functional perspective
Consider the response to change, as well as the resting measurement
What matters is not only how a function appears at rest, but how pulse, blood pressure, gaze stability, posture, breathing and perceived confidence respond to changes of position, standing or exertion. The same sequence is assessed again after a suitable input.
Practical implication:
A difficult position change is not considered in isolation. It leads directly to detailed assessment of the regulation, orientation and stabilisation systems involved.
When exertion is more than simply tiring
When even small demands overwhelm the system
In pronounced exertion intolerance, the effort felt during an activity is not the only important factor. Symptoms may appear immediately, or become significantly worse only hours later or the following day.
Why the immediate impression alone may be misleading
01
Exertion
Physical activity, prolonged standing, concentrated work or another mental or sensory demand.
02
Immediately afterwards
Some people initially feel relatively stable or notice only small changes.
03
Hours later
Exhaustion, brain fog, dizziness, pain, sensitivity to input or autonomic symptoms may increase considerably.
04
The following day
In pronounced conditions, capacity may remain reduced and recovery may take substantially longer.
Usual adaptation
Exertion leads to fatigue, followed by recovery
A physical or mental demand uses energy. Usually the system adapts and returns towards its starting level after an appropriate recovery period.
Exertion
→
Fatigue
→
Recovery
An unusual exertion pattern
A small demand may trigger a disproportionate response
It becomes problematic when even small demands lead to significant or delayed deterioration and the system takes considerably longer to stabilise again.
Small demand
→
Deterioration
→
prolonged recovery
Particularly relevant in ME/CFS
Post-exertional malaise / post-exertional symptom exacerbation
In ME/CFS, deterioration following exertion is a central feature. The terms often used are post-exertional malaise (PEM) or post-exertional symptom exacerbation (PESE).
Physical, cognitive, emotional or sensory demands may trigger delayed deterioration that can persist. Capacity must therefore not be judged solely by the immediate impression after an exercise.
In pronounced exertion intolerance, the immediate response is not the only deciding factor. The dose is maintained only if total daily demands and delayed responses also remain stable. The following hours and, where needed, the next day therefore inform further planning.
Post-infectious and neuroimmunological conditions
When an infection becomes a turning point
Some people report a significant change in their capacity or regulation after an infection. Rather than returning fully to their previous level, different symptoms persist or recur with exertion.
An infection may significantly change the functional starting point.
What matters is which regulatory areas have responded unusually since then under exertion, sensory demands or changes of position.
Several regulatory areas may respond unusually at once after an infection
Post-infectious conditions often involve more than one body system. The way different functions interact may change, with very different areas of emphasis for each person.
Capacity
Activities are tolerated less well or lead to unusually long recovery.
Circulation and autonomic regulation
Standing up, standing, heat or exertion may provoke palpitations, dizziness or circulatory symptoms.
Cognition and sensory processing
Concentration difficulties, brain fog or sensitivity to light, sound or movement may become more noticeable.
Sleep and recovery
Sleep may feel less restorative, or the body may find it harder to leave a heightened activation state.
Temperature and autonomic functions
Heat, cold, sweating, digestion or other automatic body functions may respond differently.
Balance and perception
Dizziness, light-headedness or uncertainty during movement may also form part of the overall picture.
Long Covid, EBV, Lyme disease and other infections
Post-infectious does not automatically mean Long Covid
Long Covid is a familiar example of a complex post-infectious condition. Comparable changes in capacity, sensory processing or regulation are also described after other infections. These include, for example, Epstein–Barr virus (EBV), a Lyme disease or previous Borrelia infection and other infections that may place considerable demands on the immune and nervous systems.
Depending on the individual course, these may include viral or bacterial infections. The preceding infection alone does not automatically explain current symptoms, however, and a functional test cannot diagnose an active infection or its medical cause.
For functional assessment, what matters is therefore not only which pathogen or illness came before. The relevant questions are which symptoms have persisted since then, which demands change them and how consistently different functions respond today.
Medical perspective
Which illness or pathophysiology is present?
Medical diagnosis investigates possible infectious, immunological, neurological, cardiological or other causes and disease mechanisms. Where indicated, this also includes assessment of active or past infections such as EBV or Lyme disease. A functional perspective does not replace this assessment.
Functional perspective
Which functions currently respond unusually?
As a complement, we can assess how balance, eye movements, sensory processing, exertion or other suitable functions change under defined conditions, and which inputs are currently tolerated well or poorly.
The broad symptom picture becomes a specific sequence:
identify the greatest loss of function, assess the contributing systems in detail, integrate suitable inputs and re-check the original task.
What is assessed specifically?
Observable responses make regulation more tangible
Initial neurofunctional screening shows which areas work consistently and where detailed assessment would provide the most useful information. Not everyone needs the same set of tests.
Initial screening
Make the greatest instabilities visible
Walking, posture, trunk stabilisation, eye movements, balance, coordination, breathing and signs of regulation provide the starting picture.
→
Detailed assessment
Break down a finding precisely
Side, direction, position, input type, demand conditions, functional relationships and experience-based supply assessments are examined individually.
Six areas that may be relevant in complex conditions
Selection always follows the initial screening findings and the person's target output.
Overall stability
Walking, posture, trunk stabilisation, balance and rapid alternating movements show how steadily the body is organised.
Circulation & position changes
Lying, sitting and standing are compared through pulse, blood pressure, how the person feels, gaze stability and standing control.
Breathing & interoception
Airway, rate, depth, chest movement, tension patterns and processing of internal signals are distinguished.
Eyes & orientation
Fixation, saccades, smooth pursuit, gaze stabilisation and eye–head coordination are assessed individually.
Sensory processing
Touch, pressure, joint information, vibration, temperature, sound or smell may be assessed as defined inputs.
Exertion & recovery
Speed, accuracy, breathing response, symptom course and recovery time are compared in a clearly defined task.
Do not address every area at once.
The function that stands out most is assessed in detail first, integrated appropriately and re-tested identically. Repeat screening then shows which level has priority next.
When many findings are present at once
Why complex cases often need a step-by-step neurofunctional approach
In complex conditions, functional assessment often shows more than one finding. Differences may appear at several levels at once, such as balance, eye movements, sensory processing, coordination, autonomic regulation or tolerance of exertion.
When almost every area shows a finding
The more functional findings are present at once, the harder it is initially to determine clearly which matters most for the overall picture.
Detailed work therefore begins with the functions that differ most clearly in the initial screening. They are assessed systematically, integrated and then checked again under the same conditions.
01
Record multiple findings
Initially, different sensory, motor, visual, vestibular or autonomic functions may all show findings at once.
02
Work through them systematically
Areas that stand out are assessed step by step, influenced with defined inputs and then checked again.
03
Reduce functional noise
With each finding that becomes clearer or improves, the overall picture becomes easier to interpret and relationships may become more apparent.
04
Distinguish more finely
When fewer interfering variables are present at once, more specific and complex questions can be investigated neurofunctionally.
Put simply
Clear the broad layer first — then clean the finer gaps.
While many levels show functional findings at the same time, very fine distinctions are often not yet useful. We therefore first address what stands out clearly and reproducibly. As the overall functional picture becomes clearer, questions directed at the nervous system can become more precise.
Over time, the questions can become more specific
Which particular sensory input changes a particular function?
Under which conditions does a finding become especially apparent?
Which systems influence one another?
Which combination of inputs reproducibly changes the result?
Complex cases cannot always be reduced to one central functional finding in a single session.
Sometimes several levels need to be worked through systematically first. Neurofunctional differentiation in these conditions may therefore require several sessions.
Applied Neurofunction · assess rather than guess
Identify findings, test suitable inputs and make changes directly visible
In complex cases, Applied Neurofunction provides the thread through my work. Findings are not merely identified: I immediately assess which specific input changes an unusual response positively.
Primary tool
Muscle function assessment as a precise reference test
The muscle function assessment makes it possible to compare functional changes directly and narrow questions step by step. It is connected with the neurofunctional tests that stood out in the initial screening.
Additional assessment tools
Neuroathletic tests broaden the functional picture
Depending on the question, I also use a broad set of neuroathletic tests. These may include balance, eye movements, coordination, movement quality, sensory processing or other suitable functional markers.
A functional picture develops step by step
Findings are not collected in isolation; they are investigated directly and, where possible, influenced functionally.
Define a reference test
Muscle function assessment first establishes a functional starting test that is as reproducible as possible. Suitable neuroathletic tests may complement it.
Narrow down the finding
Targeted questions and defined sensory, motor or other inputs are used to assess what changes the reference test.
Take deterioration seriously
If a finding appears or the reference test worsens, assessment does not stop at that observation. The search for a suitable input begins here.
Test a suitable input
Depending on the finding, different neurofunctional inputs are assessed specifically, such as visual, vestibular, proprioceptive, somatosensory or respiratory inputs.
Integrate the input and re-test
If an input produces a positive change, it is integrated specifically. The same reference test is then assessed again to make the change directly visible.
Address the next level
The next relevant finding follows. In complex conditions, this process may involve several functional levels and therefore several sessions.
The finding alone is not the deciding factor
When a function worsens, we look for a positive change
A functional finding is not the end result for me. The crucial question is: What changes this response back in a positive direction? If a suitable input is identified, it is integrated and the result is checked again.
I do not simply collect findings.
If a function responds unusually or worsens, I look for an input that changes the response positively, integrate it and check the result immediately in the re-test.
A particular consideration in pronounced exertion intolerance:
A good immediate re-test does not automatically mean an input will also be tolerated well later. In relevant symptom patterns, dose, total daily demands and possible delayed responses must therefore also be considered.
Three specific examples
Similar symptoms may lead to completely different assessment routes
These examples show three typical starting situations and the functional assessment logic that follows, from specific everyday experience through detailed tests to targeted integration.
01
Dizziness, palpitations and brain fog on standing up
Symptoms appear particularly with position changes, prolonged standing or warm rooms.
Initial testCompare lying, sitting and standing through pulse, blood pressure, how the person feels, gaze stability and standing control.
Detailed assessmentAssess breathing, eye–head coordination, trunk stabilisation and sensory orientation individually.
IntegrationIntegrate a suitable input, re-test the same position-change sequence and use this to identify a tolerable starting dose.
02
Exhausted and quickly overwhelmed by sensory input since an infection
Screens, movement, sounds or concentrated work use disproportionately large amounts of energy.
Initial testRecord a short visual or cognitive task through speed, errors, posture, breathing and after-effects.
Detailed assessmentCompare fixation, saccades, smooth pursuit, balance, the breathing wave and sensory inputs separately.
IntegrationStabilise the function that declines first in the test before gradually increasing overall demands.
03
Tired, but constantly activated internally
Sleep feels insufficiently restorative, the system struggles to settle and responds sensitively to new demands.
Initial testRecord breathing pattern, tension, walking, temperature, pupil responses and a functional output relevant to everyday life.
Detailed assessmentTest respiratory, interoceptive, somatosensory and autonomic inputs individually at a low dose.
IntegrationContinue only inputs that improve the functional output and remain well tolerated over time.
Assess rather than guess.
Findings are not merely identified; they are influenced specifically and then re-tested directly.
A functional look at complex symptoms
Together, identify which functions are currently unsettling your nervous system
When symptoms vary and several systems seem to be involved at once, Applied Neurofunction breaks down the overall picture into specific functions. This shows where detailed work should begin.
assess individually rather than use a general approach
re-test findings directly
work through complex conditions step by step
Common questions
Questions about autonomic dysregulation and complex symptoms
Here you can find answers to common questions about Applied Neurofunction in complex, autonomic and post-infectious symptom patterns.
What is the difference between autonomic dysregulation, vegetative dysregulation and vegetative dystonia?
In everyday use, these terms sometimes have different meanings. They often refer to symptom patterns in which automatic body functions such as circulation, activation, breathing, digestion, temperature regulation or sleep do not adapt consistently to changing demands.
For my functional work, the broad term used is less important than which functions actually respond unusually and under which conditions they change.
Can I come to you with an existing medical diagnosis?
Yes. My work addresses a different level: I assess how the nervous system currently responds to particular demands and defined inputs. The focus is on the functions that stand out individually, such as position changes, gaze stability, balance, breathing, sensory processing or tolerance of exertion.
Why are the same symptoms not always assessed in the same way?
Two people with similar symptoms may differ considerably in balance, eye movements, coordination, sensory processing, autonomic regulation or capacity, for example.
We therefore do not begin with a standard programme. The initial screening shows which functions stand out individually and where detailed tests should begin.
What happens specifically in Applied Neurofunction?
The process begins with initial neurofunctional screening. Stability, balance, eye movements, coordination and sensation are assessed, along with circulation, breathing or responses to exertion where relevant to the symptom pattern.
Areas that stand out are then broken down further in detailed tests. Muscle function assessment serves as a precise reference test for exploring individual relationships directly.
If a suitable input is found, it is integrated. The same test follows again. This immediately shows whether the function that previously stood out has improved.
Why does a complex case sometimes need several sessions?
Complex conditions often show functional findings at several levels at once. It is not always clear initially which matters most for the overall picture.
It may therefore be necessary to work through several clearly reproducible findings systematically first. Each clarified level often makes the overall picture easier to understand and allows finer differentiation.
Put simply: clear the broad layer first — then clean the finer gaps.
What if I only respond to exertion hours later?
This is particularly important in pronounced exertion intolerance. The dose is therefore not determined solely by the immediate response.
In relevant conditions, alongside direct re-tests we also consider dose, total daily demands and possible delayed responses.
In ME/CFS, possible post-exertional malaise or post-exertional symptom exacerbation is particularly important.
Do I need medical assessment before making an appointment?
For persistent or complex symptoms, medical assessment is generally useful and has often already taken place.
New, sudden, severe or previously unexplained symptoms should first be examined medically. This particularly applies to acute neurological, cardiological or other warning signs.
You are welcome to bring existing findings to the appointment.
How can I find out whether this area of focus fits my situation?
This area may be relevant if your symptoms are complex or variable, several systems seem to be involved at once or you want to understand which functions currently respond unusually alongside existing diagnostic findings.
If you are unsure, a free first conversation is the easiest starting point. We can first explore whether my functional approach broadly fits your situation.
Still unsure whether your symptoms fit here?
In a free first conversation, we can first explore together whether Applied Neurofunction fits your situation.
In a free first conversation, we can first explore together whether Applied Neurofunction fits your situation.