最近审阅: 24 十月 2020
最近更新: 29 七月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 体位性轻度头晕、晕厥和其他脑灌注不足症状

其他诊断因素

  • 帕金森症特征
  • 小脑共济失调
  • 体重减轻
  • 静息心动过速或者心率变异受损
  • 胃肠动力异常
  • 勃起功能障碍和缺少射精
  • 无汗症、畏热、皮肤干燥、局部多汗
  • 尿频、尿急、遗尿

危险因素

  • 老人
  • 衰弱和机体“去适应”
  • 损害交感神经张力的药物
  • 血容量缺失/贫血
  • 自主神经功能紊乱(比如,糖尿病)
  • 帕金森病
  • 路易体痴呆
  • 多系统萎缩症

诊断性检查

需考虑的检查

  • 倾斜试验
  • 去甲肾上腺素
  • 深呼吸
  • 咽鼓管捏鼻鼓气法
  • 神经传导检查和肌电图(EMG)
  • 定量分析汗腺运动反射试验(QSART)
  • 心律变异性
  • 24 小时血压监测
  • 自身免疫性抗体
  • 胸部 CT
  • 血清和尿液电泳
  • 脂肪垫活检
  • 基因检测
更多 需考虑的检查

治疗流程

急性处理

撰稿人

Professor of Medicine and Pharmacology

Vanderbilt University

Nashville

TN

利益声明

IB is a consultant for Theravance Biopharma and has received grant support from NIH, Theravance Biopharma, and Biohaven. IB holds a patent for an automated binder for the treatment of orthostatic hypotension. IB is an author of a number of references cited in this topic.

Assistant Professor

Dysautonomia Center

Department of Physiology and Neuroscience

NYU Langone Medical Center

New York

NY

利益声明

LNK is a board member of the American Autonomic Society. LNK is an author of a number of references cited in this topic.

Professor of Neurology

Medicine and Pediatrics

New York University School of Medicine

New York

NY

利益声明

HK has received compensation from Theravance Biopharma and Lundbeck as a consultant/advisory board member. HK is an author of a number of references cited in this topic.

同行评议者展开全部内容

Robert D. and Patricia E. Kern Professor of Neurology

Mayo Clinic College of Medicine

Rochester

MN

利益声明

PAL is an author of a reference cited in this topic.

Professor of Neurology

Mayo Clinic

Jacksonville

FL

利益声明

WPC declares that he has no competing interests.

Consultant Geriatrician

Beaumont Hospital

Dublin

Ireland

利益声明

AM has received payment from Shire Pharmaceuticals, manufacturer of midodrine, for providing educational talks, and the department in which he works has received unrestricted educational grants from Shire Pharmaceuticals.

内容使用需遵循免责声明