Clinical Autonomic Research

, Volume 11, Issue 4, pp 265–267 | Cite as

Postural tachycardia syndrome in syringomyelia: Response to fludrocortisone and β-blockers

  • Martín Nogués
  • Ricardo Delorme
  • Daniela Saadia
  • Kirsten Heidel
  • Eduardo Benarroch
Brief Communication

Abstract

Orthostatic intolerance is occasionally reported by patients with syringomyelia and is usually attributed to vestibular symptoms or neurogenic orthostatic hypotension. Postural tachycardia syndrome has not been previously described in syringomyelia. A patient with long-standing syringomyelia and a Chiari type I anomaly developed disabling “panic-like” attacks associated to orthostatic intolerance five years after posterior fossa decompression and shunting of the syrinx. A headup tilt test showed an early phase of postural orthostatic tachycardia followed by progressive arterial hypotension and bradycardia as seen in neurally mediated syncope. A magnetic resonance imaging scan showed a collapsed syrinx from the 3rd cervical to the 12th thoracic vertebra without syringobulbia. Fludrocortisone and β-blockers led to resolution of symptoms. Partial sympathetic denervation of the legs in syringomyelia might explain the occasional occurrence of postural tachycardia syndrome. Postural tachycardia syndrome may be included as a possible cause of orthostatic symptoms in syringomyelia patients.

Key words

postural tachycardia syndrome (POTS) syringomyelia syncope autonomic dysfunction 

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Copyright information

© Lippincott Williams & Wilkins 2001

Authors and Affiliations

  • Martín Nogués
    • 1
  • Ricardo Delorme
    • 1
  • Daniela Saadia
    • 1
  • Kirsten Heidel
    • 2
  • Eduardo Benarroch
    • 2
  1. 1.Department of NeurologyRaul Carrea Institute for Neurological Research (FLENI)Buenos AiresArgentina
  2. 2.Department of NeurologyMayo ClinicRochesterUSA

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