Abstract
Two cases of idiopathic orthostatic hypotension are reported, one associated with striato-nigral degeneration (case 1) and the other with Lewy body parkinsonism (case 2). In case 1, cerebrospinal fluid monoamine studies were carried out before and during treatment with 5-HTP and L-dopa. Low values of 5-HIAA appeared to be associated with degeneration of the spinal cord intermediolateral column. L-dopa had a beneficial effect on both parkinsonism and hypotension over a period of 6 months. New pathologic observations included changes in the sacral cord and a topographically related involvement of the substantia nigra and striatum, consistent with recent experimental neuroanatomical data.
Publication types
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Research Support, U.S. Gov't, Non-P.H.S.
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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5-Hydroxytryptophan / therapeutic use
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Aged
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Amines / cerebrospinal fluid
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Brain Diseases / complications
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Brain Diseases / metabolism
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Brain Diseases / pathology
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Female
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Ganglia, Autonomic / pathology
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Humans
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Hydroxyindoleacetic Acid / urine
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Hypotension, Orthostatic* / complications
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Hypotension, Orthostatic* / metabolism
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Hypotension, Orthostatic* / pathology
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Levodopa / therapeutic use
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Male
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Middle Aged
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Parkinson Disease / complications
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Parkinson Disease / drug therapy
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Parkinson Disease / pathology
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Putamen / pathology
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Spinal Cord / pathology
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Substantia Nigra / pathology
Substances
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Amines
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Levodopa
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Hydroxyindoleacetic Acid
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5-Hydroxytryptophan