This article describes the pathophysiology, clinical presentation, differential diagnosis, diagnosis, and management of postural orthostatic tachycardia syndrome (POTS), a potentially debilitating autonomic disorder that can have many causes and presentations.
POTS can be mistaken for panic disorder, inappropriate sinus tachycardia, and chronic fatigue syndrome.
Clinician suspicion for the syndrome is key to prompt patient diagnosis and treatment. Continue reading
Dysautonomia is not a single disorder, the term describes a number of conditions which affect the autonomic nervous system. This section of the nervous system controls automatic body functions, like heart rate and breathing.
dysautonomia affects an estimated 70 million people worldwide.
In this article, we will describe some of the different types of dysautonomia, their symptoms, and treatments. Continue reading
Antidepressant Efficacy in Neuropathic Pain
Although clinicians are able to identify the causes of neuropathic pain, the mechanism behind its treatment is more difficult to distinguish.
The drugs’ potential analgesic properties were noted long before in a study published in 1960.
Although tricyclic antidepressants remained the mainstay of pharmacological treatment for neuropathic pain for years, the drugs’ true mechanism wasn’t revealed until 1992. Continue reading
Dysautonomia is an umbrella term that means any dysfunction of the Autonomic Nervous System (ANS). The ANS controls the involuntary functions of the body like heart rate, blood pressure, breathing, digestion, sweating, kidney function, dilation and constriction of the pupils and more.
This is an excellent and thorough explanation of EDS and other Connective Tissue Disorders (CTDs):
Joint laxity syndromes can cause many nonspecific and variable symptoms, even among patients with the same condition, making diagnosis difficult.
Many patients see numerous specialists before receiving a proper diagnosis, as many healthcare providers are only familiar with the more extreme forms of the disease (eg, Marfan syndrome, osteogenesis imperfecta) despite milder variants being more prevalent.
This article provides an overview of the spectrum of joint laxity syndromes, examining symptoms, assessment, and workup of patients suspected to have such conditions. It also provides an overview of the role of genetic testing and of the preventive and therapeutic strategies physicians can use to improve the care of their patients. Continue reading
Joint hypermobility: emerging disease or illness behaviour | by Rodney Grahame
Joint hypermobility syndrome is a common clinical entity which is much misunderstood, overlooked, misdiagnosed and mistreated. It was first described in the 1960s as a purely musculoskeletal condition due to joint laxity and hypermobility occurring in otherwise healthy individuals.
Some four decades later it is now perceived to be a multi-systemic heritable dis- order of connective tissue with manifestations occurring far beyond the confines of the locomotor system and with ramifications potentially affecting most, if not all, of the bodily systems in one way or another.
Most authorities in the field find it clinically indistinguishable from EDS type III, the Ehlers-Danlos syndrome hypermobility type.
In > 50% of patients the diagnosis is delayed for 10 years. Failure to diagnose and treat the condition correctly results in needless pain and suffering and in many patients to a progressive decline in their quality of life and in some to a loss of independence. Continue reading
From what I’ve heard in the community, this is highly unlikely. Their suspicions are quite a stretch, and even the association doesn’t hold up, let alone causation.
POTS has been around a lot longer than this vaccine.
BACKGROUND: Infections with human papilloma virus (HPV) can result in cervical, oropharyngeal, anal, and penile cancer and vaccination programs have been launched in many countries as a preventive measure.
We report the characteristics of a number of patients with a syndrome of orthostatic intolerance, headache, fatigue, cognitive dysfunction, and neuropathic pain starting in close relation to HPV vaccination. Continue reading
In recent years there has been a substantial improvement of our understanding of POTS. Although the exact etiology remains elusive, we know that the syndrome of postural tachycardia is not a single clinical entity, but rather a heterogeneous group of various related clinical syndromes having a final common presentation of orthostatic intolerance
The commonest form of POTS, called the neuropathic or partial dysautonomic form, results from neuropathy preferentially involving the lower extremities with resultant venous pooling
Another group of patients suffer from centrally driven abnormal sympathetic activation. This form of postural tachycardia syndrome is called hyperadrenergic POTS, and comprises about 10% of all POTS patients. Patients suffering from hyperadrenergic POTS have been observed to have an orthostatic plasma norepinephrine level =600 pg/mL and a rise of systolic blood pressure (SBP) of =10 mm Hg upon standing.
Here are 2 articles from the http://www.upright-health.com/ that explain how the connective tissue laxity of EDS can lead to disturbances in CSF volume, pressure, and circulation. These changes can in turn affect the pituitary gland and hypothalamus, which then lead to a cascade of hormonal problems, not to mention terrible headaches.
Ehlers-Danlos syndrome often affects the design and function of the skull and spine. Moreover, while most cases are not affected there is a significant incidence of multiple sclerosis (MS) in patients with Ehlers-Danlos Syndrome (EDS) due to their increase in susceptibility caused by structural problems in the skull and upper cervical spine.
In fact, the connection of EDS to MS underscores the role of upper cervical subluxations, Chiari malformations and cerebrospinal fluid flow (CSF) in neurodegenerative diseases such as multiple sclerosis (MS).
Autonomic neuropathies are a collection of syndromes and diseases affecting the autonomic neurons, either parasympathetic or sympathetic, or both. Autonomic neuropathies can be hereditary or acquired in nature. Most often, they occur in conjunction with a somatic neuropathy, but they can also occur in isolation.
The autonomic nervous system modulates numerous body functions; therefore, autonomic dysfunction may manifest with numerous clinical phenotypes and various laboratory and neurophysiologic abnormalities. Although a patient may present with symptoms related to a single portion of the autonomic system, the physician must be vigilant for other affected parts of the autonomic system.In some forms, the degree and type of autonomic system involvement varies extensively.