Shy-Drager syndrome a case report with polysomnography

Aloe, F. S.; Marchiori, P.E.; Reimão, R.N.; Scaff, M.

doi:10.1590/S0004-282X1990000200018

Abstracts

The authors report a case of Shy-Drager syndrome in a 53 year-old male patient. Autonomic failure was made evident by physical examiration as well as laboratory tests. A sleep recording showed decreased percentage of REM sleep and apneas of the central type. The possible mechanisms for this sleep disorder are discussed.

É relatado o caso de um paciente de 53 anos de idade com diagnóstico de síndrome de Shy-Drager. Testes laboratoriais e exame físico evidenciaram claramente o distúrbio do sistema nervoso autônomo. Foi também obtido traçado poligráfico do sono durante uma noite completa, que mostrou diminuição do sono tipo MOR e apnéias do tipo central. Os possíveis mecanismos destes achados polissonográficos são discutidos.

F. S. Aloe; P.E. Marchiori; R.N. Reimão; M. Scaff

Divisão de Neurologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP)

SUMMARY

The authors report a case of Shy-Drager syndrome in a 53 year-old male patient. Autonomic failure was made evident by physical examiration as well as laboratory tests. A sleep recording showed decreased percentage of REM sleep and apneas of the central type. The possible mechanisms for this sleep disorder are discussed.

RESUMO

É relatado o caso de um paciente de 53 anos de idade com diagnóstico de síndrome de Shy-Drager. Testes laboratoriais e exame físico evidenciaram claramente o distúrbio do sistema nervoso autônomo. Foi também obtido traçado poligráfico do sono durante uma noite completa, que mostrou diminuição do sono tipo MOR e apnéias do tipo central. Os possíveis mecanismos destes achados polissonográficos são discutidos.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Dr. Flávio S. Alóe - Divisão de Neurologia, Hospital das Clínicas, FMUSP - Caixa Postal 3461 - 01051 São Paulo SP . Brasil

1. Bannister R - Degeneration of the autonomic nervous system. Lancet 2:175, 1971.
2. Bannister R, Mowbray J, Sidgwick A - Genetic control of progressive autonomic failure: evidence for an association with an HLA antigen. Lancet 1:1017, 1983.
3. Barr AN - The Shy-Drager syndrome. In PJ Vinken, GW Bruyn (eds): Handbook of Clinical Neurology, Volume 38. Elsevier, Amsterdam, 1983, pg. 233.
4. Blomqvist CG - Orthostatic hypotension. Hypertension 8:722, 1986.
5. Brevetti G, Chiarello M, Campanella G - Different types of orthostatic hypotension: current concepts. Acta Neurol (Napoli) 5:441, 1983.
6. Brodal B - Neurological Anatomy. Oxford Univ Press, New York, 1969, pg 698.
7. Castillo J, Garcia-Martinez I, Lema M, Noya M - Hipotensión orthostática crónica idiopática: revision de conjunto. Rev Clin Esp 5:185, 1982.
8. Cocco G, Stiozzi C, Portaluppi F, Tasini MT, Rizzo A, Alfiero R, Padula A, Montanari L - L'ipotensione ortostatica. Clin Ter 117:133, 1986.
9. Costa C, Marino O, Barletta R, Natoli A - L'ipotensione ortostatica: attuali conoscenze eziopatogenetiche diagnostiche e terapeutiche. Clin Ter 118:49, 1986.
10. Fouad FM, Tarazi RC, Bravo EL - Orthostatic hypotension: clinical experience with diagnostic tests. Cleveland Clin Q 52:561, 1985.
11. Giroud M, Guard O, Soichot P, Sautreaux JL, Thierry A, Dumas R - Hypotension arterielle orthostatique et aneurysme geant du trone basilaire. Ann Cardiol Angiol 35:27, 1986.
12. Gross M, Bannister R, Godwin-Austen R - Orthostatic hypotension in Parkinson's disease. Lancet 1:174, 1972.
13. Hanson OG Ludlow CL, Bassichi CJ - Vocal fold paresis in Shy-Drager syndrome. Ann Otol Laryngol 92:85, 1983.
14. Hohl RD, Frame B, Schatz IJ - The Shy-Drager variant of idiopathic orthostatic hypotension. Am J Med 39:134, 1965.
15. Huelgas RG, Reinoso MEC, Donate JQ, Hernandez GM - Sindrome de Shy-Drager: descripción de un caso. Rev Clin Esp 176:91, 1985.
16. Kafka MS, Polinsky RJ, Williams A, Kopin IJ, Lake CR, Ebert MH, Tokola NS - Alpha-adrentrgic receptors in orthostatic hypotension syndromes. Neurology 34:1121, 1984.
17. Kopin IJ. Folinsky RJ. Oliver JA, Oddershede IR, Ebert MH - Urynary catecholamine metabolites distinguish different types of sympathetic neuronal dysfunction patients with orthostatic hypotension. J Clin Endocr Metab 57:632, 1983.
18. Kuroywa Y, Shimada Y, Toyokura Y - Postural hypotension and low R-R interval variability in parkinsonism, spinocerebelar degeneration, and Shy-Drager syndrome. Neurology 33:463, 1983.
19. Lehrman KL, Guilleminault C, Schroeder JS, Tilkian A, Forno Nl - Sleep apnea syndrome in a patienl with Shy-Drager syndrome. Arch Intern Med 138:206, 1978.
20. Lorenzini M - Incidenza delia ipotensione ortostatica: índagine clinica su 1010 casi. Min Med 73:3395, 1982.
21. Ruchoux M, Gray F, Gherardi R, Schaeffer A, Comoy J, Poirier J - Orthostatic hypotension from a cerebellar gangliocytoma (Lhermitte Duelos disease): case report. J Neurosurg 65:245, 1986.
22. Schatz IJ - Current management concepts in orthostatic hypotension. Arch Intern Med 140:1152, 1980.
23 Schatz IJ - Orthostatic hypotension: I. Functional and neurogenic causes. Arch Intern Med 144:773, 1984.
24. Schatz IJ - Orthostatic hypotension: II. Clinical diagnosis, testing, and treatment. Arch Intern Med 144:1037, 1984.
25. Schatz IJ, Podolsky S, Frame B - Idiopathic orthostatic hypotension: diagnosis and treatment. J Am Med Assoc 186:537, 1963.
26 Schwarz GA - The orthostatic hypotension syndrome of Shy-Drager: a clinicc-pathologic report. Arch Neurol 16:123, 1967.
27. Shimizu H, Sumi K, Sugita J, Abe J, Futagi Y, Mimaki T, Yabuuchi H - Cerebral blood flow changes in orthostatic dysregulation fainters. Brain Dev 4:21, 1982.
28. Shy GM, Drager GA - A neurological syndrome associatd with orthostatic hypotension. Arch Neurol 2:511, 1960.
29. Spalding JMK, Nelson E - The autonomic nervous system. In AB Baker, LH Baker (eds): Clinical Neurology, Volume 4. Harper & Row, Philadelphia, 3985, pag 1.
30. Thomas JE, Schrirger A - Idiopathic orthostatic hipotension: a study of its natural history in 57 neurologically affected patients. Arch Neurol 22:289, 1970.
31. Thomas J.G, Schirger A. Fealey RD, Sheps SG - Orthostatic hypotension. Mayo Clin Proc 56:117 1981.
32. Thulesius O - Pathophysiological classification and diagnosis of orthostatic hypotension. Cardiology 61 (suppl. 1):180, 1976.
33. Van Der Haeghen J, Perier O, Sternon JE - Pathological findings in idiopathic orthostatic hypotension: its relationship with Parkinson's disease. Arch Neurol 22:207, 1970.
34 Wagner HN - Orthostatic hypotension. Bull J Hopk Hosp 105:322, 1959.
35. Ziegler MG, Lake R, Kopin IJ - The sympathetic nervous system defect in primary orthostatic hypotension. New Engl J Med 296:293, 1977.

Shy-Drager syndrome a case report with polysomnography

Síndrome de Shy-Drager: registro de caso com estudo polissonográfico

Publication Dates

Publication in this collection
25 May 2011
Date of issue
June 1990

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Bannister R - Degeneration of the autonomic nervous system. Lancet 2:175, 1971.

[2] 2. Bannister R, Mowbray J, Sidgwick A - Genetic control of progressive autonomic failure: evidence for an association with an HLA antigen. Lancet 1:1017, 1983.

[3] 3. Barr AN - The Shy-Drager syndrome. In PJ Vinken, GW Bruyn (eds): Handbook of Clinical Neurology, Volume 38. Elsevier, Amsterdam, 1983, pg. 233.

[4] 4. Blomqvist CG - Orthostatic hypotension. Hypertension 8:722, 1986.

[5] 5. Brevetti G, Chiarello M, Campanella G - Different types of orthostatic hypotension: current concepts. Acta Neurol (Napoli) 5:441, 1983.

[6] 6. Brodal B - Neurological Anatomy. Oxford Univ Press, New York, 1969, pg 698.

[7] 7. Castillo J, Garcia-Martinez I, Lema M, Noya M - Hipotensión orthostática crónica idiopática: revision de conjunto. Rev Clin Esp 5:185, 1982.

[8] 8. Cocco G, Stiozzi C, Portaluppi F, Tasini MT, Rizzo A, Alfiero R, Padula A, Montanari L - L'ipotensione ortostatica. Clin Ter 117:133, 1986.

[9] 9. Costa C, Marino O, Barletta R, Natoli A - L'ipotensione ortostatica: attuali conoscenze eziopatogenetiche diagnostiche e terapeutiche. Clin Ter 118:49, 1986.

[10] 10. Fouad FM, Tarazi RC, Bravo EL - Orthostatic hypotension: clinical experience with diagnostic tests. Cleveland Clin Q 52:561, 1985.

[11] 11. Giroud M, Guard O, Soichot P, Sautreaux JL, Thierry A, Dumas R - Hypotension arterielle orthostatique et aneurysme geant du trone basilaire. Ann Cardiol Angiol 35:27, 1986.

[12] 12. Gross M, Bannister R, Godwin-Austen R - Orthostatic hypotension in Parkinson's disease. Lancet 1:174, 1972.

[13] 13. Hanson OG Ludlow CL, Bassichi CJ - Vocal fold paresis in Shy-Drager syndrome. Ann Otol Laryngol 92:85, 1983.

[14] 14. Hohl RD, Frame B, Schatz IJ - The Shy-Drager variant of idiopathic orthostatic hypotension. Am J Med 39:134, 1965.

[15] 15. Huelgas RG, Reinoso MEC, Donate JQ, Hernandez GM - Sindrome de Shy-Drager: descripción de un caso. Rev Clin Esp 176:91, 1985.

[16] 16. Kafka MS, Polinsky RJ, Williams A, Kopin IJ, Lake CR, Ebert MH, Tokola NS - Alpha-adrentrgic receptors in orthostatic hypotension syndromes. Neurology 34:1121, 1984.

[17] 17. Kopin IJ. Folinsky RJ. Oliver JA, Oddershede IR, Ebert MH - Urynary catecholamine metabolites distinguish different types of sympathetic neuronal dysfunction patients with orthostatic hypotension. J Clin Endocr Metab 57:632, 1983.

[18] 18. Kuroywa Y, Shimada Y, Toyokura Y - Postural hypotension and low R-R interval variability in parkinsonism, spinocerebelar degeneration, and Shy-Drager syndrome. Neurology 33:463, 1983.

[19] 19. Lehrman KL, Guilleminault C, Schroeder JS, Tilkian A, Forno Nl - Sleep apnea syndrome in a patienl with Shy-Drager syndrome. Arch Intern Med 138:206, 1978.

[20] 20. Lorenzini M - Incidenza delia ipotensione ortostatica: índagine clinica su 1010 casi. Min Med 73:3395, 1982.

[21] 21. Ruchoux M, Gray F, Gherardi R, Schaeffer A, Comoy J, Poirier J - Orthostatic hypotension from a cerebellar gangliocytoma (Lhermitte Duelos disease): case report. J Neurosurg 65:245, 1986.

[22] 22. Schatz IJ - Current management concepts in orthostatic hypotension. Arch Intern Med 140:1152, 1980.

[23] 23 Schatz IJ - Orthostatic hypotension: I. Functional and neurogenic causes. Arch Intern Med 144:773, 1984.

[24] 24. Schatz IJ - Orthostatic hypotension: II. Clinical diagnosis, testing, and treatment. Arch Intern Med 144:1037, 1984.

[25] 25. Schatz IJ, Podolsky S, Frame B - Idiopathic orthostatic hypotension: diagnosis and treatment. J Am Med Assoc 186:537, 1963.

[26] 26 Schwarz GA - The orthostatic hypotension syndrome of Shy-Drager: a clinicc-pathologic report. Arch Neurol 16:123, 1967.

[27] 27. Shimizu H, Sumi K, Sugita J, Abe J, Futagi Y, Mimaki T, Yabuuchi H - Cerebral blood flow changes in orthostatic dysregulation fainters. Brain Dev 4:21, 1982.

[28] 28. Shy GM, Drager GA - A neurological syndrome associatd with orthostatic hypotension. Arch Neurol 2:511, 1960.

[29] 29. Spalding JMK, Nelson E - The autonomic nervous system. In AB Baker, LH Baker (eds): Clinical Neurology, Volume 4. Harper & Row, Philadelphia, 3985, pag 1.

[30] 30. Thomas JE, Schrirger A - Idiopathic orthostatic hipotension: a study of its natural history in 57 neurologically affected patients. Arch Neurol 22:289, 1970.

[31] 31. Thomas J.G, Schirger A. Fealey RD, Sheps SG - Orthostatic hypotension. Mayo Clin Proc 56:117 1981.

[32] 32. Thulesius O - Pathophysiological classification and diagnosis of orthostatic hypotension. Cardiology 61 (suppl. 1):180, 1976.

[33] 33. Van Der Haeghen J, Perier O, Sternon JE - Pathological findings in idiopathic orthostatic hypotension: its relationship with Parkinson's disease. Arch Neurol 22:207, 1970.

[34] 34 Wagner HN - Orthostatic hypotension. Bull J Hopk Hosp 105:322, 1959.

[35] 35. Ziegler MG, Lake R, Kopin IJ - The sympathetic nervous system defect in primary orthostatic hypotension. New Engl J Med 296:293, 1977.