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November 1960

Postural Hypotension Associated with Anhidrosis and Unchanging Pulse: A Case Report and Review of the Subject

Author Affiliations

Oakland, Calif.

Arch Intern Med. 1960;106(5):657-662. doi:10.1001/archinte.1960.03820050069013

In 1925, Bradbury and Eggleston1 reported three cases of severe postural hypotension associated with unchanging pulse and anhidrosis. Numerous instances of simple postural hypotension have been reported by subsequent authors; however, the symptom-complex described above has not frequently been observed.

Consensus favors a defect in the autonomic system as a responsible factor in the cases of severe orthostatic hypotension. In some patients, the deficiency in sympathetic activity is associated with a systemic disease, most often diabetes or syphilis. Barnett and Wagner2 have discussed theories as to the site of the causative lesion, particularly in the primary cases. In some cases the disorder of the vegetative system is "central," and in others it is "peripheral."

In the following, we present a case of severe postural hypotension associated with syncope, convulsions, anhidrosis, and loss of other reflex sympathetic activity.

Report of Case  A 55-year-old Negro woman entered Highland-Alameda County Hospital