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Case 9: Postural Tachycardia Syndrome, Neuropathic Type 

Case 9: Postural Tachycardia Syndrome, Neuropathic Type
Case 9: Postural Tachycardia Syndrome, Neuropathic Type

Peter Novak

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date: 23 October 2020

Postural tachycardia syndrome (POTS) can be associated with mixed small fiber neuropathy in which both epidermal and autonomic fibers are affected. Damage of sensory fibers leads to sensory symptoms (pain, numbness) while dysfunction of autonomic fibers (in this case, with adrenergic dysfunctions as detected by the Valsalva maneuver and sudomotor deficit as detected by sudomotor testing and confirmed by abnormal sweat gland nerve fibers on the skin biopsy) leads to POTS. Hypocapnia is common in POTS and reduces the cerebral blood flow velocity due to its vasoconstrictive effect.

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