Autonomic Function

Question 1

What is the definition of orthostatic hypotension

Answer 1

A fall of systolic BP of at least 20 mmHg or diastolic BP of at least 10 mmHg within 3 mins of standing

Question 2

What are some nuerological causes of primary orthostatic hypotension

Answer 2

Parkinson’s
MS
Lewy Body dementia

Question 3

Where is the lesion if a patient complains of urinary retention +/- overflow incontinence

Answer 3

Damage to S2,3,4 - either at their origin in the lower spinal cord, or in the cauda equina or pelvis

The bladder becomes palpable and may be tender (if afferent fibres are also affected)

Infection is common

Question 4

Where is the lesion if a patient complains of urgency and increased frequency of urination +/- urge incontinence

Answer 4

Lesions higher in the spinal cord - loss of supraspinal inhibition causing detrussor instability