Spectrum of autonomic dysfunction in orthostatic dizziness

Hyun-Ah KimHyon-Ah YiHyung Lee
Dept. of Neurology (신경과학); Brain Research Institute (뇌연구소)
Issue Date
Clinical Neurophysiology, Vol.125(6) : 1248-1254, 2014
Objective To investigate the frequency and detailed spectrum of autonomic dysfunction in patients with orthostatic dizziness (OD). Methods Over 20 months, 217 consecutive patients with OD as a presenting symptom of orthostatic intolerance were enrolled. The distribution and severity of autonomic dysfunction were measured by the composite autonomic severity score (CASS), which was derived from a standard autonomic function test including Finapres for recording of the beat-to-beat blood pressure. Sympathetic indexes (SIs) were calculated from the Valsalva maneuver (VM). Results Approximately 83% of patients showed at least one abnormal autonomic testing result. We classified OD into 11 groups according to the patterns of autonomic dysfunctions. The most common pattern was generalized autonomic failure of sympathetic adrenergic and parasympathetic cardiovagal functions (n = 60). Patients with delayed OH had larger BP increases during late phase II of the VM (p = 0.04), showed greater phase IV overshoot (p = 0.04), and had a smaller pressure recovery time increase (p = 0.02) than patients with classic OH. Each SI showed the strongest correlation with the CASS adrenergic subscores. Conclusions OD can present with a board spectrum of autonomic dysfunctions. Significance This investigation could be useful in understanding the pattern and mechanism of autonomic dysfunction associated with OD. Keywords Orthostatic dizziness; Autonomic dysfunction; Spectrum
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
1. Journal Papers (연구논문) > 3. Research Institutues (연구소) > Brain Research Institute (뇌연구소)
Keimyung Author(s)
김현아; 이현아; 이형
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