Baroreceptor denervation presenting as part of a vagal mononeuropathy.
A 48-year-old woman presented with a history of progressive cough, dysphonia, dysphagia, and postural symptoms. Subsequent neurological investigations were consistent with a bilateral vagal mononeuropathy, and neurosarcoidosis was diagnosed after scalene node biopsy. Autonomic investigations including microneurography, neurohormones, and heart rate variability demonstrated arterial and cardiopulmonary baroreflex failure. In addition, parasympathetic control of heart rate was absent and consistent with a bilateral, nonselective lesion in the proximal vagus.
Jardine
D L
DL
Cardiology Department, Christchurch Hospital, New Zealand. davidj@chhlth.govt.nz
Melton
I C
IC
Bennett
S I
SI
Crozier
I G
IG
Donaldson
I M
IM
Ikram
H
H
D001127:Arginine Vasopressin / Q000097:blood; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D001794:Blood Pressure; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D009132:Muscles / Q000294:innervation; D009638:Norepinephrine / Q000097:blood; D011311:Pressoreceptors / Q000503:physiopathology*; D012083:Renin / Q000097:blood; D013564:Sympathetic Nervous System / Q000503:physiopathology; D018667:Tilt-Table Test; D014630:Vagus Nerve / Q000503:physiopathology*
D001127:Arginine Vasopressin; D012083:Renin; D009638:Norepinephrine