ten Harkel A D, van Lieshout J J, Wieling W
Department of Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Clin Auton Res. 1991 Sep;1(3):215-7. doi: 10.1007/BF01824989.
A 59-year old woman who presented with postural dizziness 50 years after an acute episode of poliomyelitis is described. There were no new neurological signs and no evidence of motor neuron disease. She had postural hypotension with an abnormal Valsalva. Investigations led to a diagnosis of hypo-adrenergic orthostatic hypotension, with a predominantly preganglionic sympathetic lesion and intact vagal baroreflex pathways. Although pure autonomic failure and multiple system atrophy are possible causes of circulatory autonomic failure, no other new neurological or autonomic features have developed during a 2 year follow-up. We propose that hypo-adrenergic orthostatic hypotension may be a late complication of poliomyelitis. Deterioration in ambulatory ability in a patient with previous poliomyelitis should additionally include assessment of cardiovascular autonomic function.
本文描述了一名59岁女性，在急性脊髓灰质炎发作50年后出现体位性头晕。无新的神经系统体征，也无运动神经元病的证据。她存在体位性低血压，瓦尔萨尔瓦动作异常。检查诊断为低肾上腺素能性直立性低血压，主要为节前交感神经病变，迷走压力反射通路完整。虽然纯自主神经功能衰竭和多系统萎缩可能是循环自主神经功能衰竭的病因，但在2年的随访中未出现其他新的神经或自主神经特征。我们认为低肾上腺素能性直立性低血压可能是脊髓灰质炎的晚期并发症。既往有脊髓灰质炎病史的患者步行能力下降时，还应评估心血管自主神经功能。
