Work

Recurrent Syncope Due to Orthostatic Hypotension Following Lateral Medullary Infarction: A Case Report

Year: 2026

Type: article

Abstract: Lateral medullary infarction typically presents with sensory disturbance, cerebellar ataxia, and Horner's syndrome, whereas orthostatic hypotension is not generally considered a typical manifestation, but it may cause syncope. A 77-year-old man developed recurrent syncope during early mobilization following an acute right lateral medullary infarction. Head-up tilt testing demonstrated severe orthostatic hypotension with minimal heart rate response and inadequate plasma norepinephrine increase. Sequential treatment with midodrine, fludrocortisone, and droxidopa resolved the symptoms. Serial head-up tilt testing suggested a partial improvement in the orthostatic hemodynamic responses. Orthostatic hypotension should be considered in patients with lateral medullary infarction and positional symptoms, and serial head-up tilt testing may help document any changes in the orthostatic hemodynamic response.

Source: Internal Medicine

DOI: 10.2169/internalmedicine.7325-26

Authors: Junichi Matsuo, Yasuyuki Hara, Keiichi Nakahara, Mitsuharu Ueda

Institution: Kumamoto University

Language: English

Topic: Cardiovascular Syncope and Autonomic Disorders

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: Japan Society for the Promotion of Science