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Carotid sinus hypersensitivity associated with focal alpha-synucleinopathy of the autonomic nervous system

Lookup NU author(s): Dr Tuomo Polvikoski, Professor Raj KalariaORCiD, Emeritus Professor Robert Perry, Veronica Miller, Professor Rose Anne Kenny

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Abstract

A case of an 82-year-old woman who experienced repeated falls is described. She exhibited a cardioinhibitory carotid sinus hypersensitivity after right carotid sinus massage (CSM), but without evidence of orthostatic hypotension. After a pacemaker was implanted, she did not experience any falls, dizziness or syncope. Her balance eventually deteriorated, but she remained cognitively intact and died from lung cancer at the age of 89 years. Neuropathological examination showed only age-related Alzheimer's disease pathology and a few alpha-synuclein-positive granular deposits and neurites in the dorsal nucleus of the vagus and solitary tract nucleus in the medulla, but a marked alpha-synuclein pathology in the stellate ganglia. The cardioinhibitory element of her CSM was possibly because of the a-synuclein pathology in the ganglion, which impaired sympathetic transmission. This case shows another phenotype among patients with alpha-synucleinopathy.

Publication metadata

Author(s): Polvikoski T, Kalaria RN, Perry R, Miller V, Kenny RA

Publication type: Article

Publication status: Published

Journal: Journal of Neurology, Neurosurgery and Psychiatry

Year: 2006

Volume: 77

Issue: 9

Pages: 1064-1066

ISSN (print): 0022-3050

ISSN (electronic): 1468-330X

Publisher: BMJ Publishing Group

URL: http://dx.doi.org/10.1136/jnnp.2005.083550

DOI: 10.1136/jnnp.2005.083550

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