Cardio-Vascular Autonomic Functions in Patients With Orthostatic Dizziness and Syncope(Special Issue in Hornor of the Retirement of Professor Makoto Iwata at the Department of Neurology, Tokyo Women\u27s Medical University)

Objective: Dizziness is a common symptom in the out-patient neurology clinic. In this study, we investigate the relationship between cardio-vascular autonomic functions and dizziness in patients with orthostatic dizziness and syncope. Methods: Subjects were 100 patients (41 males, 59 females, aged from 17 to 94 years; mean ± SD; 54.6 ± 19.9) that complained "dizziness" or "syncope" without abnormalities such as brain tumor or brain hemorrhage, evaluated between June 2003 and November 2004. Blood pressure, heart rate and plethysmographic parameters under orthostatic stress and CVR-R at rest were evaluated. Results: Orthostatic hypotension (OH) was found in 32 patients, reflex arteriolar contraction insufficiency (RCI) in 45 patients and decrease of CVR-R in 25 patients. Of patients with OH, 87.5% were elderly (>60 years of age) patients. Factors of involvement in OH were RCI, decreased heat rate, CVR-R, age and ischemic findings on MRI. Conclusion: Cardio-vascular autonomic functions deteriorate over 30% in the patients with orthostatic dizziness or syncope, particularly in elderly patients. These results suggested that cardio-vascular autonomic dysfunction would be involved in causing dizziness.神経内科学教室岩田誠教授退任記念特別