Subclinical autonomic disturbances in multiple sclerosis.
We compared results from non-invasive autonomic testing [sympathetic skin responses (SSR), heart beat variation during deep breathing, and orthostatic manoeuvre with transcranial Doppler monitoring in 22 patients] with motor and somatosensory evoked potentials (MEP and SEP) in 30 unselected patients with multiple sclerosis. We found a similarly high yield of pathological results for SSR, MEP and SEP (66.7%, 65.5%, and 69%, respectively). When analysed for each limb (n = 120), SSR were highly correlated with MEP and SEP (for both P < 0.001). Heart beat variation was reduced in only 3 patients. In 4 of 22 patients orthostatic manoeuvre induced a pathological decrease in cerebral blood flow velocity despite normal systemic blood pressure being maintained. We conclude that SSR may be a useful additional diagnostic tool in patients with multiple sclerosis. Cerebral dysautoregulation is a rather frequent finding, although its significance is not known.
Linden
D
D
Department of Neurology and Clinical Neurophysiology, Alfried Krupp Hospital, Essen, Germany.
Diehl
R R
RR
Berlit
P
P
D000293:Adolescent; D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D019054:Evoked Potentials, Motor / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011446:Prospective Studies; D013223:Statistics as Topic; D017585:Ultrasonography, Doppler, Transcranial