Postural orthostatic tachycardia syndrome associated with multiple sclerosis

Autonomic dysfunction in multiple sclerosis

“…POTS is characterized by sustained heart rate increase on orthostatic challenge without concomitant OH and is associated with symptoms of orthostatic intolerance [14]. POTS has been reported to occur frequently in MS and the connection of the two entities is explained by the presence of demyelinating brainstem and hemispheral lesions disrupting the physiological heart rate variability modulation [10,14].…”

“…POTS has been reported to occur frequently in MS and the connection of the two entities is explained by the presence of demyelinating brainstem and hemispheral lesions disrupting the physiological heart rate variability modulation [10,14]. Almost half of POTS patients complain of fatigue and the concomitant appearance of POTS and MS aggravates the dire sense of fatigue that MS patients often experience [15].…”

Clinical Neurophysiology of Multiple Sclerosis

“…It is characterized by sustained heart rate increase on orthostatic challenge without concomitant OH (40). PoTS is recognized to be present in MS more frequently than in healthy controls and its presence is explained by demyelinating brainstem and hemispheral lesions disrupting the physiological heart rate variability modulation (42,43). Although the true significance of PoTS in MS is not completely elucidated, it is known that PoTS patients have a restricted ability to exercise and an increased sensation of fatigue, which may aggravate preexisting symptoms in MS. Another factor adding to the problem of fatigue in MS is reduced vagal activity that is seen to occur at a younger age in MS (44).…”

A Step Toward Moving Forward in Autonomic Nervous System Research

“…1 Over the past two decades, improved testing has allowed us to recognize not only new syndromes characterized by orthostatic intolerance (such as postural orthostatic tachycardia syndrome), but also to recognize the high percentage of ANS involvement in neurological diseases such as multiple sclerosis. 2 If we know that symptoms attributable to ANS involvement are frequent in both general population (mostly functional ANS disorder) as well as population suffering from various neurological diseases (mostly structural ANS disorder), it is surprising that testing of the ANS is still not widely used and available. There are several reasons for this: 1) more tests of autonomic function exist than for any other neurological system; 2) autonomic function tests are indirect, relatively imprecise, and fraught with difficulties; 3) numerous technical and physiologic variables must be controlled for; autonomic regulation is slow, intricate, and complex; and the visceral physiological systems being regulated are themselves intricate and complex.…”