The Orthostatic Hypotension Syndrome of Shy-Drager

Schwarz, Gabriel A.

doi:10.1001/archneur.1967.00470200011002

Cited by 44 publications

(13 citation statements)

References 17 publications

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“…Since no changes were found in the hypothalamus or in peripheral autonomic ganglia, it is reasonable to ascribe the patient's autonomic disorder to the observed loss of preganglionic autonomic cells. 'Schwarz (1967) has expressed doubt as to the possibility of making significant evaluations of cell loss by counting methods. Variations in cell density certainly exist from level to level and from section to section.…”

Section: Case Reportmentioning

confidence: 99%

“…The lesions were those of olivo-ponto-cerebellar atrophy; in addition, there was cell loss, estimated at about 75 %, in the intermediolateral columns. Since then, there have been four reports on cases that have gone to necropsy-that of Nick, Contamin, Escourolle, Guillard, and Marcantoni (1967) and the two cases of Schwarz (1967)-all of which showed neuronal degeneration at various sites, including the inter-28 mediolateral columns; and the case of Martin, Travis, and van den Noort (1968), which showed no relevant CNS pathology.…”

mentioning

confidence: 99%

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Orthostatic hypotension and nicotine sensitivity in a case of multiple system atrophy.

Graham¹,

Oppenheimer²

1969

Journal of Neurology, Neurosurgery & Psychiatry

510

183

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Section: Case Reportmentioning

confidence: 99%

mentioning

confidence: 99%

Orthostatic hypotension and nicotine sensitivity in a case of multiple system atrophy.

Graham¹,

Oppenheimer²

1969

Journal of Neurology, Neurosurgery & Psychiatry

510

183

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“…Parkinson's disease and multiple system atrophy can be distinguished clinically (Bannister and Oppenheimer, 1972). In multiple system atrophy the pathological basis of autonomic failure, including orthostatic hypotension, is loss of cells in the intermediolateral column in the spinal cord (Johnson et al, 1966;Schwartz, 1967;Chokroverty et al, 1969;Bannister and Oppenheimer, 1972). In idiopathic paralysis agitans the pathological basis of dysautonomia is not yet established.…”

mentioning

confidence: 99%

Dysautonomia in Parkinsonism: a clinicopathological study.

Rajput¹,

Rozdilsky²

1976

Journal of Neurology, Neurosurgery & Psychiatry

153

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SYNOPSIS Necropsy studies were done on six patients with idiopathic paralysis agitans, one with multiple system atrophy including features of Parkinsonism, and one control. Autonomic functions had been evaluated during life to a varying degree. Intra-arterial blood pressure studies were carried out on two patients with paralysis agitans (cases 4 and 6) and the one with multiple system atrophy (case 7). Lewy bodies with or without cell loss were seen in the sympathetic ganglia of five cases of paralysis agitans. Three of these had orthostatic hypotension and the severity of the lesion approximately correlated with the degree of hypotension. It is concluded that the lesions of the sympathetic ganglia may play a major role in the production oforthostatic hypotension in idiopathic paralysis agitans.Autonomic dysfunction in Parkinson's disease was first reported in 1817 by James Parkinson himself. Abnormalities of salivation, sweating, bladder and bowel function are common features of the disease he described, and orthostatic hypotension, though less common, is perhaps the most disturbing form of dysautonomia. Parkinsonism features may also occur in multiple system atrophy of which progressive autonomic failure may be a predominant feature. Parkinson's disease and multiple system atrophy can be distinguished clinically (Bannister and Oppenheimer, 1972). In multiple system atrophy the pathological basis of autonomic failure, including orthostatic hypotension, is loss of cells in the intermediolateral column in the spinal cord (Johnson et al., 1966;Schwartz, 1967;Chokroverty et al., 1969;Bannister and Oppenheimer, 1972 One patient who suffered from brain tumour was used as a control. All patients were admitted to hospital. A detailed history of onset and progression of symptoms was obtained and an inquiry into constipation, urinary retention or incontinence, anal sphincter problem, sexual impotence, unusual sweating, seborrhoea, sialorrhoea, oculogyric crisis, and postural dizziness was made in each case. The severity of major manifestations of Parkinsonism-tremor, rigidity, and bradykinesia-was graded by the criteria of Webster (1968). Global disability was measured using the criteria of Hoehn and Yahr (1967

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“…Death is mainly caused by intercurrent infections of the respiratory tract at about 10 years from the onset. Few cases have a better prognosis [Schwarz, 1967;Kluysken et al, 1977;Allain et al, 1979;Singh and Fahn, 19801.…”

Section: Ment Intermittent Self Catheterizationmentioning

confidence: 99%