ORTHOSTATIC hypotension may be primary or secondary. The clinical syndrome of primary idiopathic orthostatic hypotension is characterized by inability to sustain standing blood pressure without the development of pallor or of tachycardia.1 Other findings include anhidrosis, impotence, urinary urgency or retention, alternating constipation and diarrhea, and a variety of disturbances directly pointing to disease of the central nervous system.2 Evidences of central nervous system disease include dysarthric or monotonous speech, diplopia, pupillary irregularities, vertigo, rigidity, tremor, cerebellar ataxia, and incontinence.2
Orthostatic hypotension, as a secondary phenomenon, occurs in a wide variety of disease states and after bed rest. Interest in orthostatic hypotension has been stimulated by its development after space flights.3 Sustained orthostatic hypotension has been described in neuropathies (diabetic,4 porphyric,5 nutritional), in myasthenia gravis,6 in paraplegia of varied causes, in Wernicke's encephalopathy,7,8 in combined systems disease,9 in tumors of
Martin JB, Travis RH, van den Noort S. Centrally Mediated Orthostatic Hypotension: Report of Cases. Arch Neurol. 1968;19(2):163–173. doi:10.1001/archneur.1968.00480020049005
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