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Pure Autonomic Failure: A Case Report of Recurrent Orthostatic Hypotension
Prabin Khatri1, Himal Panth2, Sabina Khadka3
1Department of Internal Medicine, Universal College of Medical Sciences, Bhairahawa, Nepal.
JNMA; Journal of the Nepal Medical Association
|September 11, 2021
Summary
Pure autonomic failure, a neurodegenerative disorder, can cause recurrent orthostatic hypotension and syncope. Early consideration and specific autonomic testing are crucial for diagnosis and effective treatment with medications like midodrine.
Area of Science:
- Neurology
- Autonomic Neuroscience
Background:
- Pure autonomic failure (PAF) is a neurodegenerative disorder impacting the autonomic nervous system.
- Clinical presentation often includes orthostatic hypotension, a significant drop in blood pressure upon standing.
Observation:
- A 68-year-old male presented with recurrent syncope (loss of consciousness) upon standing over three years.
- Clinical examination revealed autonomic dysfunction, with other investigations yielding normal results.
Findings:
- The case highlights the importance of considering PAF in the differential diagnosis of recurrent orthostatic hypotension.
- Autonomic dysfunction tests are essential for evaluating patients with unexplained syncope.
Implications:
- Early and accurate diagnosis of PAF can lead to timely and effective management.
- Pharmacological interventions such as midodrine and fludrocortisone, alongside non-pharmacological strategies, can successfully treat symptoms.
- Increased awareness of PAF is recommended for recurrent orthostatic hypotension cases.
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