Division of Cardiology, Section of Electrophysiology, Department of Medicine, Health Sciences Campus, University of Toledo Medical Center, Toledo, OH, USA.
Cardiol J. 2010;17(5):482-7.
Autonomic dysregulation (also called diencephalic epilepsy) has been reported following traumatic brain injuries (TBI). However, until now, postural tachycardia syndrome (POTS) has not been reported as a long-term complication in patients who have suffered a TBI. We report on a series of patients who developed POTS after suffering TBI.
Eight patients who were referred to our center had suffered TBI and developed features of orthostatic intolerance following head trauma. The patients' neurological, neurosurgical and autonomic data (charts and/or physician letters) were then carefully reviewed for demographic characteristics, comorbid conditions, symptoms of orthostatic intolerance, medications and response to medication. These patients were diagnosed as having POTS, primarily based on their clinical features and findings from the head-up tilt test (HUTT). The data presented is observational and descriptive (percentages or means).
Eight patients (seven of them women) aged 21-41 years had suffered from TBI and had developed features of POTS. All had been normal with no symptoms prior to their TBI. All patients experienced orthostatic dizziness, fatigue, palpitations and near syncope. Six patients suffered from frank syncope. Six patients developed significant cognitive dysfunction, and three developed a chronic pain syndrome following trauma. All of the patients reported severe limitations to their daily activities and had been unable to keep their jobs, and two were housebound. Six patients demonstrated a good response to therapy with various combinations of medication. The symptoms of orthostatic intolerance and syncope improved with the initiation of medical therapy, as well as their reported quality of life. Two patients failed to show any improvement with various combinations of medications and tilt training, and continued to experience orthostatic difficulties.
Postural tachycardia syndrome may, in some cases, be a late complication of traumatic brain injury.
自主神经功能紊乱（也称为间脑性癫痫）在颅脑损伤（TBI）后已有报道。然而，到目前为止，体位性心动过速综合征（POTS）尚未被报道为 TBI 患者的长期并发症。我们报告了一系列 TBI 后发生 POTS 的患者。
我们中心收治的 8 名患者因 TBI 导致头部外伤后出现直立不耐受的特征。然后仔细查阅患者的神经学、神经外科和自主神经数据（图表和/或医生信件），以了解人口统计学特征、合并症、直立不耐受症状、药物和药物反应。这些患者主要根据其临床特征和直立倾斜试验（HUTT）结果被诊断为 POTS。所呈现的数据为观察性和描述性（百分比或平均值）。
8 名患者（其中 7 名为女性）年龄 21-41 岁，患有 TBI 并出现 POTS 特征。所有患者在 TBI 前均正常，无症状。所有患者均出现直立性头晕、疲劳、心悸和近乎晕厥。6 名患者出现明显晕厥。6 名患者在创伤后出现明显认知功能障碍和慢性疼痛综合征。所有患者报告说日常活动严重受限，无法工作，其中 2 人无法出门。6 名患者对各种药物组合治疗反应良好。随着药物治疗的开始，直立不耐受和晕厥的症状以及他们报告的生活质量都有所改善。2 名患者对各种药物组合和倾斜训练均无改善，继续出现直立困难。
在某些情况下，体位性心动过速综合征可能是颅脑损伤的迟发性并发症。
