Ann Rehabil Med.  2012 Jun;36(3):418-422. 10.5535/arm.2012.36.3.418.

Amyotrophic Lateral Sclerosis with an Acute Hypertensive Crises

• Lee HL
• Lee JK

• KMID: 2266751
• DOI: http://doi.org/10.5535/arm.2012.36.3.418

Abstract

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder involving the systemic motor neurons, but autonomic nervous function is relatively well preserved. A few studies related to autonomic dysfunction have been reported, but autonomic dysfunction is rare in ALS. Moreover, dysautonomia symptoms are not prominent in patients with ALS. We present a 55-year-old male patient with ALS, who had acute severe hypertension and tachycardia crises, as well as sudden falls in his blood pressure. After he was diagnosed with ALS, he suddenly collapsed and was placed under mechanical ventilation. Several hypertensive attacks and dysautonomic signs then occurred. We successfully controlled the dysautonomia using diazepam and doxazocin mesylate, an alpha receptor antagonist.

Keyword

Amyotrophic lateral sclerosis; Autonomic dysfunction; Hypertensive attack

MeSH Terms

Amyotrophic Lateral Sclerosis
Blood Pressure
Diazepam
Humans
Hypertension
Male
Mesylates
Middle Aged
Motor Neurons
Neurodegenerative Diseases
Primary Dysautonomias
Respiration, Artificial
Tachycardia
Diazepam
Mesylates

Figure

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  Fig. 1 Brain magnetic resonance imaging shows diffuse hypoxic brain damage.

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  Fig. 2 Alterations in the patient's systolic (SBP), diastolic blood pressure (DBP), heart rate (HR), and body temperature (BT) during hypertensive attacks and the response to intravenous administration of nicardipine (5 mg) and labetalol (10 mg).

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  Fig. 3 Alterations in the patient's systolic (SBP), diastolic blood pressure (DBP), heart rate (HR), and body temperature (BT) during hypertensive attacks and the response to intravenous administration of diazepam (2 mg).

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