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[HTLV-1 Associated Myelopathy (HAM) With Severe Orthostatic Hypotension--A Case Report]

[HTLV-1 Associated Myelopathy (HAM) With Severe Orthostatic Hypotension--A Case Report]

M Takao, T Yamawaki, N Suzuki

Rinsho Shinkeigaku. 1994 Aug;34(8):842-4.

PMID: 7994995

Abstract:

We present a case of HAM with severe orthostatic hypotension. A 62-year-old woman was admitted to Mito Red Cross Hospital because of orthostatic dizziness and severe gait disturbance. Physical examination revealed a severe orthostatic hypotension (142/90 mmHg (supine) vs. 84/70 mmHg (standing)). Neurological examination revealed weakness and hyperreflexia in the lower extremities, as well as extensor plantar response and spastic gait. In tests of autonomic nervous system, there was no reflex bradycardia in Aschner eye ball pressure test and carotial sinus reflex, no overshoot in Valsalva test, and electrocardiogram revealed a low value in CVR-R. The imprint techniques under 1% pilocarpine subcutaneous administration revealed a marked disturbance of sudomotor function. Blood cell counts, blood chemistry and urinalysis were unremarkable. The serological examination revealed a high titer value of anti-HTLV-1 antibody. Anti-HTLV-1 antibody and oligoclonal IgG band were detected in the cerebrospinal fluid. Magnetic resonance imaging (MRI) of the cerebrum demonstrated multiple small high intensity areas in the white matter, but these lesions showed no gadolinium enhancement. Since the test of the autonomic nervous system revealed both sympathetic and parasympathetic disturbance, it is important to investigate the autonomic disturbance including orthostatic hypotension in cases of HAM.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP1021902102	Mito Red		1021902-10-2	Price

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