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Updated: Sep 13, 2025

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Clinical Reasoning: A 63-Year-Old Female Patient Presenting With Orthostatic Hypotension and Ataxia
Fred Shen1, Edith L Graham1, Puneet Opal1
1From the Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL.
Abstract:
A 63-year-old female patient presents with orthostatic hypotension and slowly progressive cerebellar ataxia. Neurologic examination revealed ataxia, pyramidal signs, and vibration/proprioception deficits. Neuroimaging showed diffuse white matter abnormalities, cord atrophy, and corticospinal tract involvement. This case highlights how a careful history, with special attention to tempo of symptoms and family history, combined with examination findings and neuroimaging can be used to reach a rare diagnosis.
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