Clinical Autonomic Research

, Volume 4, Issue 3, pp 99–103 | Cite as

The head and neck discomfort of autonomic failure: An unrecognized aetiology of headache

  • David Robertson
  • Dawn Wade Kincaid
  • Virginia Haile
  • Rose Marie Robertson
Research Paper


Information concerning the frequency, severity, character, location, duration, diurnal pattern of headache and ancillary symptoms were obtained in 25 patients with autonomic failure and 44 control subjects. Precipitating and ameliorating factors were identified. Autonomic failure patients had more head and neck discomfort than controls. Their discomfort was much more likely to localize in the occiput, nape of the neck and shoulder, compared with controls. There was a greater tendency for the discomfort to occur in the morning and after meals. It was sometimes less than 5 min in duration and was often associated with dimming, blurring, or tunnelling of vision. It was provoked by upright posture and relieved by lying down. Patients with severe autonomic failure and orthostatic hypotension often present with a posturedependent headache or neck pain. Because the relationship of these symptoms to posture is often not recognized, the fact that these findings may signal an underlying autonomic disorder is underappreciated, and the opportunity to consider this aetiology for the headache may be missed.

Key words

Headache Shy—Drager syndrome Multiple system atrophy Bradbury—Eggleston syndrome Pure autonomic failure Neck pain 


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Copyright information

© Rapid Communications of Oxford Ltd 1994

Authors and Affiliations

  • David Robertson
    • 1
  • Dawn Wade Kincaid
    • 1
  • Virginia Haile
    • 1
  • Rose Marie Robertson
    • 1
  1. 1.Autonomic Dysfunction Center, Departments of Medicine, Pharmacology and NeurologyVanderbilt UniversityNashvilleUSA

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