| Title | Vagolysis. | | Author(s) | Hutchinson CD, Jardine DL, Hurrell M | | Institution | Canterbury District Health Board, Christchurch, New Zealand. Christopher.Hutchinson@cdhb.govt.nz | | Source | Age Ageing 2008 Sep; 37(5):602-4. | | MeSH | Aged
Baroreflex
Blood Pressure
Carcinoma, Squamous Cell
Catecholamines
Diagnosis, Differential
Ear Canal
Ear Neoplasms
Fatal Outcome
Glossopharyngeal Nerve Diseases
Heart Rate
Humans
Hypertension
Hypotension, Orthostatic
Magnetic Resonance Imaging
Male
Muscle, Skeletal
Radiation Injuries
Radiotherapy
Recurrence
Sympathetic Nervous System
Vagus Nerve Diseases
| | Abstract | We describe the case of a 75-year-old man presenting with labile hypertension and symptomatic postural hypotension 13 months following radiotherapy for squamous cell carcinoma of his external auditory canal. Magnetic resonance image (MRI) scan demonstrated scarring and a probable recurrence of his tumour. He underwent autonomic testing, including muscle sympathetic nerve activity (MSNA), heart rate (HR) and blood pressure (BP) responses to a variety of stimuli. Results were consistent with baroreflex failure. Urinary catecholamine levels were within the high normal range. We postulate that baroreflex failure was caused by vagal and glossopharyngeal nerve damage secondary to radiotherapy and tumour recurrence. This diagnosis is rare, but should be considered with pure autonomic failure and phaeochromocytoma in the presence of labile hypertension, especially in patients with a history of radiotherapy to the neck and high-normal catecholamine levels. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
| | PubMed ID | 18556705 |
|
