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Recurrent syncope secondary to autonomic dysfunction in spinal cord injury: a case report

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Abstract

High-level spinal cord injuries are often associated with autonomic impairment, which can result in orthostatic hypotension and syncope. Persistent autonomic dysfunction can manifest with disabling symptoms including recurrent syncopal events. We describe a case of autonomic failure resulting in recurrent syncopal events in a tetraplegic 66-year-old man.

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Fig. 2: Twenty-four-hour ambulatory BP monitor.
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Data availability

All relevant data related to this case are available as part of the article. Clinical data related to this case are retained by the medical records department at Royal Rehab, and are unavailable for release due to legislative requirements regarding patient confidentiality.

Change history

  • 10 August 2023

    In Table 1, Mental StressTest was corrected to Mental Stress Test.

References

  1. Claydon VE, Steeves JD, Krassioukov A. Orthostatic hypotension following spinal cord injury: understanding clinical pathophysiology. Spinal Cord. 2006;44:341–51.

    Article  CAS  PubMed  Google Scholar 

  2. Canosa-Hermida E, Mondelo-García C, Ferreiro-Velasco ME, Salvador-de la Barrera S, Montoto-Marqués A, Rodríguez-Sotillo A, et al. Refractory orthostatic hypotension in a patient with a spinal cord injury: treatment with droxidopa. J Spinal Cord Med. 2018;41:115–8.

    Article  PubMed  Google Scholar 

  3. Ong ETE, Yeo LKP, Kaliya-Perumal AK, Oh JYL. Orthostatic hypotension following cervical spine surgery: prevalence and risk factors. Glob Spine J. 2020;10:578–82.

    Article  Google Scholar 

  4. Krassioukov A, Eng JJ, Warburton DE, Teasell R. A systematic review of the management of orthostatic hypotension following spinal cord injury. Arch Phys Med Rehabil. 2009;90:876–85.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jacob G, Robertson D, Mosqueda-Garcia R, Ertl AC, Robertson RM, Biaggioni I. Hypovolemia in syncope and orthostatic intolerance role of the renin-angiotensin system. Am J Med. 1997;103:128–33.

    Article  CAS  PubMed  Google Scholar 

  6. Mathias CJ. editor. Autonomic failure: a textbook of clinical disorders of the autonomic nervous system. 5th ed. Oxford: Oxford Univ. Press (Oxford Medical Publications); 2013. p. 897.

  7. Shouman K, Vanichkachorn G, Cheshire WP, Suarez MD, Shelly S, Lamotte GJ, et al. Autonomic dysfunction following COVID-19 infection: an early experience. Clin Auton Res. 2021;31:385–94.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Austroads NTC and Assessing Fitness to Drive 2022. Austroads. https://austroads.com.au/publications/assessing-fitness-to-drive/ap-g56/blackouts/medical-standards-for-licensing. Accessed 1 Dec 2022.

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Funding

No external funding was received for the production of this manuscript. LS and RH are both employees of Royal Rehab, which was not involved in the creation, content or decision to publish this manuscript.

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Authors and Affiliations

  1. Spinal Injuries Unit, Royal Rehab, 235 Morrison Rd, Putney, 2112, NSW, Australia

    Leon Smith & Roxana Heriseanu

Authors
  1. Leon Smith
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  2. Roxana Heriseanu
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Contributions

LS and RH were both involved in the clinical management of the patient’s care. LS authored the initial manuscript and RH provided a review and comments.

Corresponding author

Correspondence to Leon Smith.

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The authors declare no competing interests.

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Informed consent was provided by the patient for publication of this case.

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Smith, L., Heriseanu, R. Recurrent syncope secondary to autonomic dysfunction in spinal cord injury: a case report. Spinal Cord Ser Cases 9, 23 (2023). https://doi.org/10.1038/s41394-023-00585-3

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