Tafler Leonid, Chaudry Aysham, Cho Heejin, Garcia Angeles
Primary Care, Touro College of Osteopathic Medicine, New York City, USA.
Medical School, Touro College of Osteopathic Medicine, Middletown, USA.
Cureus. 2023 Feb 15;15(2):e35009. doi: 10.7759/cureus.35009. eCollection 2023 Feb.
Postural Orthostatic Tachycardia Syndrome (POTS) is a rare disorder of the autonomic nervous system. The number of people afflicted with this dysautonomia has increased dramatically in recent years due to the long-term effects of coronavirus disease (COVID-19); however, it is largely underdiagnosed. This case report is about a patient with post-viral neuropathic POTS. Neuropathic POTS is believed to be due to the damage of small nerve fibers that regulate the constriction of the blood vessels in the limb and abdomen, which leads to interference with vasoconstriction, and therefore causes tachycardia. Current literature emphasizes a treatment that is based on lifestyle modifications, such as increasing water and salt intake, and symptomatic pharmacological treatment. In this case, the 39-year-old male ptient was treated with osteopathic manipulative treatment (OMT), specifically the compression of the fourth ventricle (CV4), which has been associated with the production of hyperparasympathetic and anti-inflammatory effects and, hence, helps overcome the small-fiber neuropathy caused by the viral illness. We found that the CV4 technique led to the successful remission of the patient's symptoms. Therefore, we propose craniosacral therapy as a successful single management modality in patients with POTS.
体位性直立性心动过速综合征（POTS）是一种罕见的自主神经系统疾病。近年来，由于冠状病毒病（COVID-19）的长期影响，患有这种自主神经功能障碍的人数急剧增加；然而，它在很大程度上未被诊断出来。本病例报告是关于一名患有病毒感染后神经性POTS的患者。神经性POTS被认为是由于调节四肢和腹部血管收缩的小神经纤维受损，这会干扰血管收缩，从而导致心动过速。当前文献强调基于生活方式调整的治疗方法，如增加水和盐的摄入量，以及对症药物治疗。在本病例中，这位39岁的男性患者接受了整骨手法治疗（OMT），特别是第四脑室压迫（CV4），这与产生副交感神经亢进和抗炎作用有关，因此有助于克服由病毒感染引起的小纤维神经病变。我们发现CV4技术使患者的症状成功缓解。因此，我们提出颅骶疗法作为POTS患者一种成功的单一治疗方式。
