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In addition to orthostatic hypotension, supine hypertension, where the BP is excessively high lying down, is a frequent problem in multiple system atrophy. Treatment of one symptom can easily aggravate the other, and supine hypertension in such patients has been linked to the same cardiovascular complications as essential hypertension. [73]
They include multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD). Dementia with Lewy bodies (DLB), may or may not be part of the PD spectrum, but it is increasingly recognized as the second-most common type of neurodegenerative dementia after Alzheimer's disease.
[12] [13] Further research identified multiple causes for these syndromic findings, now grouped as primary autonomic disorders (also called primary dysautonomia), including Pure Autonomic Failure, Multiple System Atrophy, and Parkinson's. The primary differentiating characteristic of Pure autonomic failure is decreased circulation and synthesis ...
Neurodegenerative diseases include amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease, Alzheimer's disease, Huntington's disease, multiple system atrophy, tauopathies, and prion diseases. Neurodegeneration can be found in the brain at many different levels of neuronal circuitry, ranging from molecular to systemic. [4]
Multiple sclerosis, meningitis-retention syndrome [13] Paraneoplastic syndrome [25] Spinal cord injury [13] or traumatic brain injury [26] Synucleinopathy, a group of neurodegenerative diseases including pure autonomic failure, Parkinson's disease, dementia with Lewy bodies and multiple system atrophy [6] Surgery or injury involving the nerves [13]
Multiple system atrophy (Shy–Drager syndrome) [6] Neuroacanthocytosis [6] Neuronal ceroid lipofuscinosis [6] Olivopontocerebellar atrophy [6] Pantothenate kinase-associated neurodegeneration, also known as neurodegeneration with brain iron accumulation [6] Parkin mutation causing hereditary juvenile dystonia [6] Parkinson's disease [6]
In an earlier study, 18 advanced PD patients received staged or simultaneous bilateral one or more subthalamotomy. One patient subsequently developed multiple system atrophy signs and was excluded from further analysis. Motor improvements compared to baseline were 58% in the off state and 63% in the on state.
For hypotension, it is specifically used in the treatment of neurogenic orthostatic hypotension (NOH) in dopamine β-hydroxylase deficiency, [7] as well as NOH associated with multiple system atrophy (MSA), [9] familial amyloid polyneuropathy (FAP), and pure autonomic failure (PAF). [10]
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