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Orthostatic Hypotension in Multiple System Atrophy.

Riley1

  • 1Department of Neurology, Case Western Reserve University School of Medicine, 1000 Euclid Avenue, Lakeside 3200, Cleveland, OH 44106, USA. David.Riley@uhhs.com

Current Treatment Options in Neurology
|November 30, 2000
PubMed
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Treating orthostatic hypotension in multiple system atrophy (MSA) offers symptom relief. While no cure exists for MSA, various interventions can manage autonomic dysfunction and improve patient quality of life.

Area of Science:

  • Neurology
  • Autonomic Dysfunction
  • Pharmacology

Background:

  • Multiple system atrophy (MSA) is a progressive neurodegenerative disorder.
  • Autonomic disturbances, particularly orthostatic hypotension (OH), are common and debilitating in MSA.
  • Currently, no treatments can slow or cure the progression of MSA.

Purpose of the Study:

  • To review and discuss available treatment options for orthostatic hypotension in patients with MSA.
  • To highlight interventions that can alleviate symptoms and improve the quality of life for individuals with MSA.

Main Methods:

  • Review of non-pharmacologic interventions for milder symptoms, including dietary changes, activity modifications, and compression devices.
  • Discussion of pharmacologic treatments for syncopal patients, focusing on efficacy, side effects, and cost.

Related Experiment Videos

  • Evaluation of specific medications such as midodrine, fludrocortisone, propranolol, indomethacin, and desmopressin.

    • Main Results:

    • Non-pharmacologic measures can manage milder forms of OH.
    • Midodrine is identified as a highly effective and well-tolerated medication for OH, despite higher costs.
    • Fludrocortisone is beneficial but may cause edema; other agents like propranolol, indomethacin, and desmopressin offer additional therapeutic options.

    Conclusions:

    • A range of therapeutic strategies exists for managing orthostatic hypotension in MSA.
    • These interventions provide physicians with options to alleviate patient suffering and address a disabling complication of MSA.
    • Effective management of OH contributes to improved patient outcomes and quality of life in the context of MSA.