Shy - Drager's syndrome

Outlined also called Shy - Drager's syndrome orthostatic hypotension. is no clear etiology of the disease and the basis of "idiopathic orthostatic hypotension." Cause pathogenesis is still unclear. Shy stressed that the disease of the nervous system of the original disease, may be a primary in the central nervous system or peripheral autonomic nervous system dysfunction. Clinical features of the vertical position when there vertigo, syncope, blurred vision, general weakness, and so on. Supine blood pressure normal But standing systolic and diastolic blood pressure can drop 3 ~ 5kpa (20 ~ 40 mmHg) or more. Light longer upright person developed symptoms that arise immediately vertical syncope, it took a long time bedridden. The incidence of middle-aged men disappearing slow onset. Male patients early symptoms of impotence and loss of libido, difficulty urinating, female patients to easily tired, vertigo, which is not heat-resistant, and so on. Progressive development of orthostatic hypotension, rectum atrophy, eye muscle paralysis, muscle rigidity, tremor, ataxia, distal limb muscle atrophy, occasionally dysphagia, tendon hyperreflexia and pathological reflex positive, no sensory dysfunction and mental retardation. Autonomic tests (test sweating, skin scratch tests, Vaisalva movements test) positive. Electromyography and muscle biopsy suggested neuron disease. Differential diagnosis (1) Simple syncope (simple syncope) of the disease is more obvious incentives such as pain, fear, syncope are short of prodromal symptoms, such as dizziness, nausea, pale and sweating, and so on. Syncope most often occurred in vertical spaces or spaces at ease, no significant change in vertical position of the special relationship, fast, no significant sequelae. (2) micturition syncope (micturition syncope) or urination occurred at the end of urination, Reflex cause hypotension and syncope. The most commonly occurred in patients between midnight and wake up urine, early in the morning or take a nap when up urine can also occur. (3) Carotid sinus syndrome (carotid sinus syndrome) is sensitive carotid sinus caused increased. Standing in the carotid sinus stimulation or by neighboring lesions, occurred when tight collar. Carotid sinus pressure test heart rate, blood pressure dropped and caused syncope. (4) syringomyelia (srringomyelia) Refer Morvan's syndrome. (5) Other encephalitis and sympathetic trunk resection or injury, adrenal dysfunction, diabetes, porphyrin disorders, primary amyloidosis, also can cause secondary orthostatic hypotension. Taking certain drugs, such as chlorpromazine, guanidine B acridine, also from the patients suddenly standing lying when syncope.