Pathological Findings in Idiopathic Orthostatic Hypotension

IN 1925, Bradbury and Eggleston¹isolated from among the diverse forms of orthostatic hypotension a clinical entity of slow progressive course characterized by neurological signs, in addition to orthostatic hypotension and slow fixed pulse rate. This condition is now generally recognized as "idiopathic orthostatic hypotension" (IOH).²The associated neurological symptoms vary from case to case and may include pyramidal, extrapyramidal, cerebellar, and lower motor neuron syndromes. They are slight and indefinite in the cases of Bradbury and Eggleston.¹Their onset may be delayed many years after the postural changes, or they may even be absent, as in seven of the 30 cases of Thomas and Schirger.³Tremor, rigidity, and frozen facial expression are particularly frequent, and sometimes the clinical picture mimics Parkinson's disease, as in 13 of the 15 cases of Schatz and his colleagues⁴and in 11 of the 23 neurological cases of