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Neurogenic orthostatic hypotension: pathophysiology, evaluation, and management

2012; Springer Science+Business Media; Volume: 260; Issue: 9 Linguagem: Inglês

10.1007/s00415-012-6736-7

1432-1459

Manuela Metzler, Susanne Duerr, Roberta Granata, Florian Krismer, David Robertson, Gregor K. Wenning,

Sympathectomy and Hyperhidrosis Treatments

Neurogenic orthostatic hypotension is a distinctive and treatable sign of cardiovascular autonomic dysfunction. It is caused by failure of noradrenergic neurotransmission that is associated with a range of primary or secondary autonomic disorders, including pure autonomic failure, Parkinson's disease with autonomic failure, multiple system atrophy as well as diabetic and nondiabetic autonomic neuropathies. Neurogenic orthostatic hypotension is commonly accompanied by autonomic dysregulation involving other organ systems such as the bowel and the bladder. In the present review, we provide an overview of the clinical presentation, pathophysiology, epidemiology, evaluation and management of neurogenic orthostatic hypotension focusing on neurodegenerative disorders.