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Related Experiment Videos

Orthostatic hypotension in a case with multiple sclerosis

R Sakakibara1, M Mori, T Fukutake

  • 1Department of Neurology, Chiba University School of Medicine, Japan. sakaki@med.m.chiba-u.ac.jp

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|June 1, 1997
PubMed
Summary

This case study details a multiple sclerosis patient experiencing syncope and neurological symptoms. Treatment with steroids and L-threo-3,4-dihydroxyphenylserine improved brainstem signs and reduced fainting spells.

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Area of Science:

  • Neurology
  • Neuroimmunology

Background:

  • Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
  • MS can manifest with diverse neurological symptoms, impacting quality of life.

Observation:

  • A 37-year-old woman with a 5-year history of MS presented with recurrent syncope, hiccup, flushing, and ataxia.
  • Neurological examination revealed Horner's syndrome, facial hypoalgesia, hyperreflexia, sensory ataxia, and transverse myelopathy.
  • Head-up tilt testing demonstrated orthostatic hypotension with blunted heart rate response.

Findings:

  • Magnetic Resonance Imaging (MRI) showed abnormal signal intensities in the medulla oblongata and pontine tegmentum.
  • These brainstem lesions were hypothesized to contribute to the patient's orthostatic hypotension.

Related Experiment Videos

  • Treatment with pulsed steroids and L-threo-3,4-dihydroxyphenylserine led to symptom improvement.

    • Implications:

    • This case highlights potential brainstem involvement in MS-related autonomic dysfunction.
    • Early diagnosis and targeted therapy may alleviate severe symptoms like syncope in MS patients.
    • Further research into MS-related autonomic dysfunction and treatment strategies is warranted.