Neurologic Manifestations in Idiopathic Orthostatic Hypotension

Abstract

The occurrence of orthostatic hypotension in organic neurologic diseases is well documented. Lesions interfering with the regulation of blood pressure during postural changes may be situated anywhere in the central or peripheral nervous system and may be space occupying, vascular, inflammatory, or traumatic.¹However, after eliminating patients with evidence of known underlying disease, there remains a group of patients with orthostatic hypotension in whom all attempts to demonstrate an etiology have been fruitless. These patients are said to have idiopathic orthostatic hypotension (I.O.H.). In most of these patients, the evolution of the disease has a recognizable pattern. Most commonly, symptoms develop over a period of years, and the presenting complaint is either postural dizziness or bowel and bladder dysfunction. In time, other autonomic manifestations become evident, such as impairment of libido and potency and inability to perspire freely. Several years after onset, neurologic symptoms and signs may develop which