Key result
Cold oral stimulation with an ice cube altered autonomic variables but did not prevent orthostatic blood pressure drops (168/82 to 104/72 mmHg) in a patient with multiple system atrophy.
Why the study?
The study was conducted to reconsider methods for preventing orthostatic hypotension in multiple system atrophy.
Does cold oral stimulation prevent orthostatic hypotension in a patient with multiple system atrophy?
Case Report (n=1)
No
Does cold oral stimulation prevent orthostatic hypotension in a patient with multiple system atrophy?
Cold oral stimulation altered autonomic variables but failed to prevent orthostatic hypotension in a patient with multiple system atrophy, suggesting the presence of impaired venomotor tone.
May support cold oral stimulation for orthostatic hypotension in MSA; leaves open need for controlled trials.
[Purpose] The aim of this case study is to reconsider the method for preventing orthostatic hypotension in multiple system atrophy. [Participant and Methods] The case was that of a 70-year-old female with multiple system atrophy who experienced frequent falls and orthostatic hypotension. An orthostatic test was performed, and the effect of cold oral stimulation before standing was compared with no stimulation. Outcome measures were blood pressure, heart rate variability and autonomic variables. [Results] In the control test, blood pressure decreased from 150/72 mmHg in the supine position to 98/58 mmHg in the standing position. Heart rate increased from 71 bpm to 82 bpm, high frequency declined from 16.48 msec2 to 14.07 msec2, and low/high frequency increased from 2.56 to 5.13. Cold stimulation in the standing position induced changes in blood pressure from 168/82 mmHg to 104/72 mmHg, heart rate from 73 bpm to 83 bpm, high frequency from 61.29 msec2 to 24.56 msec2, and low/high frequency from 1.45 to 6.33 msec2. [Conclusion] Standing after cold stimulation affected autonomic variables, but did not affect the heart rate or blood pressure, possibly because of damaged peripheral blood vessels. Further research is required to demonstrate the effect of cold stimulation on orthostatic hypotension.
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Uzawa et al. (2020) conducted a case report in Multiple system atrophy with orthostatic hypotension (n=1). Cold oral stimulation (ice cube) vs. No stimulation was evaluated on Blood pressure and heart rate upon standing. Cold oral stimulation with an ice cube altered autonomic variables but did not prevent orthostatic blood pressure drops (168/82 to 104/72 mmHg) in a patient with multiple system atrophy.
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