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J Neurol Sci. 2014 Sep 15;344(1-2):165-70. doi: 10.1016/j.jns.2014.06.048. Epub 2014 Jun 29.

Autonomic dysfunction in chronic persistent dizziness.

Author information

1
Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, Republic of Korea.
2
Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, Republic of Korea. Electronic address: kha0206@dsmc.or.kr.

Abstract

OBJECTIVE:

To investigate the autonomic dysfunction in patients with chronic persistent dizziness using standardized autonomic function tests.

METHODS:

We prospectively recruited 18 patients with chronic persistent dizziness after excluding other causes with extensive investigations. A standardized battery of autonomic tests including the head up tilt (HUT) test, Valsalva maneuver (VM), and heart rate (HR) response to deep breathing was performed.

RESULTS:

Approximately eighty percent of the patients showed at least one abnormality in autonomic tests. Two patterns of autonomic abnormality were identified: sympathetic failure, including abnormal decrease in blood pressure (BP) during HUT test or abnormal sympathetic indices related with the BP recovery during late phase II and phase IV during VM, and sympathetic hyperactivity, including abnormal increase in HR response during HUT test or an exaggerated phase IV response manifesting increased β-adrenergic tone during VM.

CONCLUSIONS:

Autonomic dysfunction is frequently found in patients with chronic persistent dizziness after excluding other causes with extensive investigations. Sympathetic failure or hyperactivity may be postulated as one of the possible causes of chronic persistent dizziness. Clinicians should be aware of the possibility of autonomic dysfunction in patients with chronic dizziness, even if the dizziness is not orthostatic but persistent.

KEYWORDS:

Autonomic nervous system; Chronic disease; Dizziness; Sympathetic nervous system diseases; Tilt-table test; Valsalva maneuver

PMID:
25012479
DOI:
10.1016/j.jns.2014.06.048
[Indexed for MEDLINE]

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