Pure Autonomic Failure (PAF)
PAF is an uncommon disorder affecting people during midlife but can occur at all ages. It is the presence of orthostatic hypotension and no evidence of other neurological problems. The Orthostatic Hypotension must not be caused by outside sources such as medications. Many medications cause OH particularly antidepresents. PAF is also known as Bradbury-Egglestone Syndrome.
The autonomic nervous system controls the respiratory and cardiovascular systems of the body. This enables different body systems to work together in harmony to carry out daily activities such as exercise and digestion.
Common symptoms include :
- Postural hypotension - to simplify, a drastic drop in pressure when going from a lying or sitting position to a standing posistion
- Changes in sweating
- Digestive problems
- Impotence
- Bladder disturbances
- Fatigue
Other symptoms:
- Dizziness
- Light Headedness
- Blackouts
- Nausea
- Vision problems
- Headaches
Diagnosis
Due to the vagueness and fluctuations of symptoms, diagnose is often difficult.
Factors that affect diagnosis are:
- Time of day
- Medications
- Environmental factors such as temperature
Hypotension diagnosis must be done with a detailed history of the patients blood pressure as well as other symptoms. A single blood pressure reading will not suffice and readings are done in a lying, sitting, and standing position. Often time blood tests and brain scans are done to rule out similar diseases
PAF is life altering but does not alter life exoectancy. Often progression is followed by long periods of stability. It is a chronic ilness and therefore can be disabling.
Treatment includes:
- Avoiding situations that induce symptoms (e.g. hot baths that lower blood pressure
- Changes to diet
- To help control blood pressure
- Avoid constipation
- The use of medications
- To raise blood pressure
- Strengthen bladder tone
- Prevent constipation