Upright tilt-table testing induced significant hypotension in all 7 adolescents with chronic fatigue, suggesting an overlap with neurally mediated hypotension.
Case Report (n=7)
Does treatment of neurally mediated hypotension improve symptoms in adolescents with chronic fatigue?
Neurally mediated hypotension may be an unrecognized cause of chronic fatigue syndrome in adolescents, and treatment with atenolol or disopyramide may improve symptoms.
Neurally mediated hypotension is now recognised as a common cause of otherwise unexplained recurrent syncope, but has not been reported in association with chronic fatigue. We describe seven consecutive non-syncopal adolescents with chronic post-exertional fatigue, four of whom satisfied strict criteria for chronic fatigue syndrome. Upright tilt-table testing induced significant hypotension in all seven (median systolic blood pressure 65 mm Hg, range 37-75), consistent with the physiology of neurally mediated hypotension. Four had prompt improvement in their chronic fatigue when treated with atenolol or disopyramide. These observations suggest an overlap in the symptoms of chronic fatigue syndrome and neurally mediated hypotension.
Rowe et al. (1995) conducted a case report in Chronic post-exertional fatigue (n=7). Upright tilt-table testing was evaluated on Induction of significant hypotension. Upright tilt-table testing induced significant hypotension in all 7 adolescents with chronic fatigue, suggesting an overlap with neurally mediated hypotension.