Open AccessPure Autonomic Failure with Asymptomatic Hypertensive Urgency: A Case Report and Literature Review
Author(s) -
Alwaleed Aljohar,
Taim Muayqil,
Abdulrahman Aldeeri,
Anwar A. Jammah,
Ahmad Hersi,
Khalid F. AlHabib
Publication year - 2018
Publication title -
case reports in neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.207
H-Index - 15
ISSN - 1662-680X
DOI - 10.1159/000495605
Subject(s) - midodrine , medicine , fludrocortisone , asymptomatic , subclinical infection , supine position , pure autonomic failure , ambulatory blood pressure , ambulatory , intensive care medicine , blood pressure , refractory (planetary science) , pediatrics , surgery , orthostatic vital signs , hydrocortisone , physics , astrobiology
We report the case study of a 70-year-old gentleman who presented with isolated, slowly progressive dizziness after prolonged standing and was eventually diagnosed with pure autonomic failure. Initially, his symptoms improved with the use of midodrine and fludrocortisone, but gradually became refractory and disabling. Despite multiple therapeutic interventions, his symptoms persisted along with worsening supine hypertension. We discuss the challenges faced in the treatment of an uncommon condition and discuss the clinical utility of performing serial 24-h ambulatory monitoring to detect subclinical blood pressure fluctuations.