Symptoms Predictive of Postural Tachycardia Syndrome (<scp>POTS</scp>) in the Adolescent Headache Patient

Heyer, Geoffrey L.; Fedak, Erin M.; LeGros, Aggie L.

doi:10.1111/head.12103

Cited by 26 publications

(13 citation statements)

References 27 publications

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“…102 -104 In a study of adolescent headache patients in a tertiary-care setting, 53% had POTS. 105 Although headache can be a symptom of OI, the relationship is unclear. The treatment of POTS has been found to be only partially effective in relieving headache.…”

Section: Immune Mechanismsmentioning

confidence: 99%

Pediatric Disorders of Orthostatic Intolerance

et al. 2018

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Orthostatic intolerance (OI), having difficulty tolerating an upright posture because of symptoms or signs that abate when returned to supine, is common in pediatrics. For example, ∼40% of people faint during their lives, half of whom faint during adolescence, and the peak age for first faint is 15 years. Because of this, we describe the most common forms of OI in pediatrics and distinguish between chronic and acute OI. These common forms of OI include initial orthostatic hypotension (which is a frequently seen benign condition in youngsters), true orthostatic hypotension (both neurogenic and nonneurogenic), vasovagal syncope, and postural tachycardia syndrome. We also describe the influences of chronic bed rest and rapid weight loss as aggravating factors and causes of OI. Presenting signs and symptoms are discussed as well as patient evaluation and testing modalities. Putative causes of OI, such as gravitational and exercise deconditioning, immune-mediated disease, mast cell activation, and central hypovolemia, are described as well as frequent comorbidities, such as joint hypermobility, anxiety, and gastrointestinal issues. The medical management of OI is considered, which includes both nonpharmacologic and pharmacologic approaches. Finally, we discuss the prognosis and long-term implications of OI and indicate future directions for research and patient management.

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Section: Immune Mechanismsmentioning

confidence: 99%

Pediatric Disorders of Orthostatic Intolerance

et al. 2018

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“…88,89 Approximately two-thirds of patients with chronic daily headache have dizziness, and two-thirds of patients with POTS have headaches. Sometimes it is difficult to differentiate what symptoms the headache disorder is causing, and what symptoms should be attributable to POTS.…”

Section: Potsmentioning

confidence: 99%

Adolescent Fatigue, POTS, and Recovery: A Guide for Clinicians

Kizilbash

Ahrens

Bruce

et al. 2014

Current Problems in Pediatric and Adolescent Health Care

111

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Many teenagers who struggle with chronic fatigue have symptoms suggestive of autonomic dysfunction that may include lightheadedness, headaches, palpitations, nausea, and abdominal pain. Inadequate sleep habits and psychological conditions can contribute to fatigue, as can concurrent medical conditions. One type of autonomic dysfunction, postural orthostatic tachycardia syndrome, is increasingly being identified in adolescents with its constellation of fatigue, orthostatic intolerance, and excessive postural tachycardia (more than 40 beats/min). A family-based approach to care with support from a multidisciplinary team can diagnose, treat, educate, and encourage patients. Full recovery is possible with multi-faceted treatment. The daily treatment plan should consist of increased fluid and salt intake, aerobic exercise, and regular sleep and meal schedules; some medications can be helpful. Psychological support is critical and often includes biobehavioral strategies and cognitive–behavioral therapy to help with symptom management. More intensive recovery plans can be implemented when necessary.

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“…A recent study demonstrated that 53% of adolescent subjects with headache met criteria for the syndrome through tilt-table testing [6]. It was not surprising that our sample identifi ed headache as the most prevalent type of chronic pain encountered.…”

Section: Discussionmentioning

confidence: 67%

“…The link between POTS, the symptom of pain, and chronic pain syndromes has been discussed in many recent studies and reviews [6][7][8]. Chronic pain syndromes that are often related to a diagnosis of POTS are headache and migraine, functional abdominal pain syndromes, and fi bromyalgia [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Chronic pain syndromes that are often related to a diagnosis of POTS are headache and migraine, functional abdominal pain syndromes, and fi bromyalgia [6][7][8]. Other symptoms of chronic pain that may not specifi cally be associated with a chronic pain syndrome have also been detailed in patients with POTS, which include widespread body, joint, chest, and bladder pain [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Pain is a Prevalent Symptom of Adolescents at Diagnosis with Postural Orthostatic Tachycardia Syndrome

Bettini¹,

Fabian²,

Moak³

2017

Open J Pain Med

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Pain is often endorsed by patients with postural orthostatic tachycardia syndrome (POTS). A retrospective chart analysis of adolescents diagnosed with PTS from January 2014-December 2015 at the pediatric cardiology clinic at Children's National Health System were reviewed. 93% of the subjects reported pain at the time of diagnosis, with 46% of the sample reporting more than one site of pain. Since chronic pain syndromes and POTS are associated by similar symptom burden and often develop after illness or injury, both may be a product of pathology stemming from neuroinfl ammation and neuralplasticity that results in central sensitization and autonomic nervous system dysfunction.

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Symptoms Predictive of Postural Tachycardia Syndrome (POTS) in the Adolescent Headache Patient

Abstract: While no single clinical symptom or headache type reliably establishes the POTS diagnosis, several symptoms can help to distinguish the POTS patient in an adolescent headache population.

Cited by 26 publications

References 27 publications

Pediatric Disorders of Orthostatic Intolerance

Pediatric Disorders of Orthostatic Intolerance

Adolescent Fatigue, POTS, and Recovery: A Guide for Clinicians

Pain is a Prevalent Symptom of Adolescents at Diagnosis with Postural Orthostatic Tachycardia Syndrome

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