| Symptoms associated with orthostatic hypotension in pure autonomic failure and multiple system atrophy. | |
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MedLine Citation:
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PMID: 10552235 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The symptoms caused by or relating to orthostatic hypotension (over 20 mmHg systolic blood pressure) were evaluated using a questionnaire in 72 patients with primary chronic autonomic failure, 32 of whom had pure autonomic failure (PAF, and 40 multiple system atrophy (MSA). The most common posturally related symptoms were dizziness (84% PAF, 83% MSA), syncope (91% PAF, 45% MSA), visual disturbances (75% PAF, 53% MSA) and suboccipital/paracervical 'coat-hanger' neck pain (8 l% PAF, 53% MSA). Chest pain occurred mainly in patients with PAF (44% PAF, 13% MSA). Improvement occurred with sitting or lying flat. Non-specific symptoms (weakness, lethargy and fatigue) were common in both groups (91% PAF, 85% MSA); six patients (one PAF, five MSA) had these symptoms only. Postural symptoms (mainly dizziness and neck pain) were worse in the morning and with warm temperature, straining, exertion, arm movements and food ingestion; they were more common in PAF. Compensatory autonomic symptoms, such as palpitations and sweating, did not occur in either group. In conclusion, orthostatic hypotension caused symptoms of cerebral hypoperfusion (syncope, dizziness and visual disturbances); neck pain, presumably due to muscle hypoperfusion, also occurred frequently. These symptoms were exacerbated by various factors in daily life and were relieved by returning to the horizontal. Non-specific symptoms (such as fatigue) also were common. In MSA, despite substantial orthostatic hypotension, fewer patients had syncope, visual disturbance and neck pain; the reasons for this are unclear. Lack of these features does not exclude the need to assess and investigate orthostatic hypotension and possible autonomic failure. |
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Authors:
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C J Mathias; R Mallipeddi; K Bleasdale-Barr |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neurology Volume: 246 ISSN: 0340-5354 ISO Abbreviation: J. Neurol. Publication Date: 1999 Oct |
Date Detail:
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Created Date: 1999-12-07 Completed Date: 1999-12-07 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0423161 Medline TA: J Neurol Country: GERMANY |
Other Details:
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Languages: eng Pagination: 893-8 Citation Subset: IM; S |
Affiliation:
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Neurovascular Medicine Unit, Division of Neurosience and Psychological Medicine, Imperial College School of Medicine at St Mary's Hospital, Praed Street, London W2 INY, UK. c.mathias@ic.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adaptation, Physiological Aged Aged, 80 and over Autonomic Nervous System / physiopathology Autonomic Nervous System Diseases / complications* Brain Ischemia / etiology Female Humans Hypotension, Orthostatic / complications, etiology*, physiopathology* Male Middle Aged Multiple System Atrophy / complications* Posture |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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