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ABS TRACT Orthostatic hypotension (OH) is an important clinical issue that may adversely affect the rehabilitation process in patients with spinal cord injury (SCI). In some clinical situations where OH is nonresponsive to non-pharmacological approaches, it may be beneficial to use midodrine for the treatment of OH, which is a potent vasoconstrictive agent. A 62-year-old male patients with C4 AIS C chronic spinal cord injury, he have OH associated with spinal cord injury admitted to hospital for the long term rehabilitative care. Rehabilitation program couldn’t be maintained as a result of OH. Midodrine therapy was started to remove the OH. OH was completely improved with midodrine therapy and the patient was finally able to sit. During the treatment, rate of Autonomic Dysreflexia (AD) was increased, hence, the midodrin dosage was lowered to the level at which the AD was at least seen, and the treatment continued. The patient then was discharged from the hospital at a wheelchair-dependent level. The midodrine was observed to be effective for the treatment of OH in patients with SCI. AD, however, should be kept in mind that its frequency may increases as a side effect of midodrine therapy.

Midodrine Treatment in a Patient with Orthostatic Hypotension Associated with Spinal Cord Injury