title: Abnormal cardiovascular responses to postural changes and pharmacologic agents in a case of Shy-Drager syndrome.
abstract: A 64-year-old carpenter had an unsteady gait, severe dizziness, nocturia, and a loss of erection for more than 4 years. The neurological manifestations consisted of a wide-based ataxic gait, bilateral dysmetria with intentional tremor, staccato speech, rigidity, bradykinesia, and an iris-thinning. There was reproducible orthostatic hypotension. A sweat test revealed severe anhidrosis. Nicotine and methylbenzene sensitivity was absent, whereas norepinephrine infusion test showed a significant elevation of blood pressure. The resting plasma norepinephrine level on recumbency was low and a subnormal surge was noted on standing or exercise. We conclude that the clinical features caused by a degenerative process involving both the central and peripheral autonomic systems, together with atrophy of other systems in this patient, constitute the Shy-Drager syndrome.
authors.forename: J S
authors.initials: JS
authors.lastname: Liu
authors.forename: S S
authors.initials: SS
authors.lastname: Liu
authors.forename: W H
authors.initials: WH
authors.lastname: Chan
authors.forename: P Y
authors.initials: PY
authors.lastname: Shii
authors.forename: S L
authors.initials: SL
authors.lastname: Howng
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011187:Posture; D012791:Shy-Drager Syndrome / Q000503:physiopathology*
chemical_list: D009638:Norepinephrine