Autonomic hyperreflexia in pure progressive autonomic failure

Abstract

A 60-year-old woman suffered from recurrent episodes of fever, hypertension, facial flushing, vomiting, stridor, slowly progressive symptoms of hypohidrosis, and orthostatic hypotension. The episodes were synchronous with elevated catecholamine concentration in plasma and urine. This is an example of paroxysmal autonomic hyperreflexia in a setting of pure progressive autonomic failure.

The flushing patient: Differential diagnosis, workup, and treatment

“…Flushing has been reported in patients with Parkinson's disease, dysautonomia and orthostatic hypotension, migraines, multiple sclerosis, brain tumors, epilepsy, and spinal cord lesions that produce autonomic hyperreflexia. 1,8,[59][60][61][62][63][64][65][66][67][68][69] Flushing in patients with Parkinson's disease, migraines, and multiple sclerosis is due to vasodilation and autonomic dysfunction. 1 Furthermore, flushing due to damaged trigeminal nerves or migraine may be examples of the so-called antidromic sensorineural flushing.…”