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[Shy-Drager syndrome]

E Miron1, S Yagana, S Ben-Asouli

  • 1Medical Dept., Poriah Hospital, Tiberias.

Harefuah
|February 1, 1995
PubMed
Summary

Shy-Drager syndrome, a rare neurological disorder, was diagnosed in an elderly patient presenting with autonomic dysfunction and falls. Treatment with Fluorinef resolved postural hypotension and prevented further falls.

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Area of Science:

  • Neurology
  • Autonomic Dysfunction

Background:

  • Elderly patient with significant comorbidities including chronic pulmonary disease and ischemic heart disease.
  • History of chronic constipation, urinary incontinence, and repeated falls.
  • Presented with significant autonomic dysfunction including orthostatic hypotension.

Observation:

  • Physical examination revealed bilateral pulmonary rales, pupillary abnormalities, generalized hyperreflexia, and bilateral Babinski sign.
  • Laboratory findings included anemia, elevated ESR, hyperglobulinemia, and transient renal insufficiency.
  • Imaging studies showed cerebral and cerebellar atrophy, arterial calcifications, and small infarcts.

Findings:

  • Diagnosis of Shy-Drager syndrome was confirmed through ECG monitoring and serum noradrenaline levels during postural changes.
  • The patient exhibited classic signs of autonomic failure, including significant drops in blood pressure upon assuming a supine position.

Implications:

  • Early diagnosis and treatment of Shy-Drager syndrome can significantly improve patient outcomes.
  • Management of autonomic dysfunction, particularly orthostatic hypotension, is crucial in preventing falls and improving quality of life.
  • This case highlights the importance of a comprehensive diagnostic approach for complex neurological presentations in the elderly.

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