Head-Up Tilt Sleeping to Treat Orthostatic Intolerance in a Patient with Advanced Parkinson's Disease: A Case Report.

IF 0.6 Q4 CLINICAL NEUROLOGY

Case Reports in Neurology Pub Date : 2024-09-17 eCollection Date: 2024-01-01 DOI:10.1159/000541424

Amber H van der Stam, Sharon Shmuely, Nienke M de Vries, Roland D Thijs, Mirjam van Kesteren-Biegstraaten, Bastiaan R Bloem

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引用次数: 0

Abstract

Introduction: Orthostatic hypotension is common in people with Parkinson's disease (PD) due to autonomic dysfunction and medication use and can have a significant negative impact on quality of life. Pharmacological treatment is often complicated due to complex blood pressure regulation problems. This case report presents a patient whose symptoms of orthostatic intolerance were successfully treated with the non-pharmacological method of head-up tilt sleeping (HUTS).

Case presentation: A 69-year-old man with PD and prominent autonomic failure received recommendation from the neurologist to use HUTS to battle orthostatic intolerance, of which complaints were worst in the early morning. The patient noted a marked improvement of the orthostatic intolerance after a period in which he slowly step-by-step inclined the bed to an angle just over 10°. When ceasing HUTS for a brief period, complaints of orthostatic intolerance immediately returned and the patient returned to tilted sleeping right away. After a follow-up of 3 months, the patient did not report orthostatic intolerance during a standing test.

Conclusion: This case illuminates that, despite difficulties intrinsic to this method, whole-body HUTS can ameliorate orthostatic intolerance and improve the daily life of people with advanced movement disorders.

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用仰卧睡眠法治疗晚期帕金森病患者的直立性不耐受：病例报告。

简介：帕金森病（Parkinson's disease，PD）患者由于自主神经功能障碍和药物使用，常会出现直立性低血压，并对生活质量产生严重的负面影响。由于复杂的血压调节问题，药物治疗往往比较复杂。本病例报告介绍了一位患者，他采用非药物治疗方法--抬头仰卧睡眠法（HUTS）成功治疗了正压性不耐受症状：一位 69 岁的男性患者患有帕金森病，自主神经功能明显衰竭，神经科医生建议他使用 HUTS 来对抗正压性不耐受症状，该症状在清晨最为严重。患者注意到，在他一步步缓慢地将床倾斜到刚刚超过 10° 的角度一段时间后，他的直立性不耐受症状得到了明显改善。短暂停止 HUTS 后，患者立即又出现了正压性不耐受的症状，并立即恢复了倾斜睡眠。经过 3 个月的随访，患者在进行站立测试时未再报告正压性不耐受：本病例表明，尽管这种方法本身存在困难，但全身 HUTS 可以改善晚期运动障碍患者的正压性不耐受，并改善其日常生活。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Neurology Medicine-Neurology (clinical)

CiteScore

1.50

自引率

0.00%

发文量

审稿时长

14 weeks

期刊介绍： This new peer-reviewed online-only journal publishes original case reports covering the entire spectrum of neurology. Clinicians and researchers are given a tool to disseminate their personal experience to a wider public as well as to review interesting cases encountered by colleagues all over the world. To complement the contributions supplementary material is welcomed. The reports are searchable according to the key words supplied by the authors; it will thus be possible to search across the entire growing collection of case reports with universally used terms, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.