- Pure autonomic failure
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Pure autonomic failure, also known as Bradbury-Eggleston syndrome or idiopathic orthostatic hypotension, is a form of
dysautonomiathat first occurs in middle age or later in life; men are affected more often than women. It is one of three diseases classified as primary autonomic failure.
A degenerative disease of the
peripheral nervous system, symptoms include dizzinessand fainting(caused by orthostatic hypotension), visual disturbances and neck pain. Chest pain, fatigue and sexual dysfunctionare less common symptoms that may also occur. Symptoms are worse when standing; sometimes one may relieve symptoms by laying down.
pathologyof pure autonomic failure is not yet completely understood. However, a loss of cells in the intermediolateral column of the spinal cordhas been documented, as has a loss of catecholamineuptake and catecholamine fluorescence in sympathetic postganglionic neurons. In general, levels of catecholamines in these patients are very low while lying down, and do not increase much upon standing.
Pharmacological methods of treatment include
fludrocortisone, midodrine, somatostatin, erythropoietin, and other vasopressoragents. However, often a patient with pure autonomic failure can mitigate his or her symptoms with far less costly means. Compressing the legs and lower body, through crossing the legs, squatting, or the use of compression stockingscan help. Also, ingesting more water than usual can increase blood pressure and relieve some symptoms.
It is named for
Samuel Bradburyand Cary Eggleston. [WhoNamedIt|synd|2102] [S. Bradbury, C. Eggleston. Postural hypotension: A report of three cases. American Heart Journal, St. Louis, 1925, 1: 73-86.]
* [http://www.mc.vanderbilt.edu/root/vumc.php?site=adc&doc=4790 Vanderbilt Autonomic Dysfunction Center]
* [http://www.ndrf.org National Dysautonomia Research Foundation (NDRF)]
* [http://www.supportdysautonomia.org Dysautonomia Support Network]
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