Shy-Drager syndrome
Alternative names:
neurologic orthostatic hypotension; Shy-McGee-Drager syndrome
Symptoms:
- dizziness or fainting when arising or after standing still
- impotence
- loss of sweating of any part of the body
- loss of control of bowels or bladder
- vision changes, decreased or blurred vision
- muscle rigidity
- stiffness
- difficulty bending arms or legs
- posture may be unstable, stooped, or slumped over
- movement difficulties
- slow movements
- difficulty beginning to walk, difficulty initiating any voluntary movement
- small steps followed by the need to run to maintain balance
- freezing of movement when the movement is stopped, unable to resume movement
- muscle aches and pains (myalgia)
- shaking, tremors (may present in varying degrees, may not be present)
- may occur at rest or at any time
- may become severe enough to interfere with activities
- may be worse when tired, excited, or stressed
- finger-thumb rubbing (pill rolling tremor) may be present
- changes in facial expression
- reduced ability to show facial expressions
- "mask" appearance to face
- staring
- may be unable to close mouth
- voice and/or speech changes
- difficulty chewing or swallowing (occasionally)
- loss of fine motor skills
- difficulty writing, may be small and illegible
- difficulty eating
- difficulty with any activity that requires small movements
- frequent falls
- mild decline in intellectual function (may occur)
Additional symptoms that may be associated with this disease:
Signs and tests:
An eye examination may reveal atrophy of the iris and paralysis of eye muscles. Postural hypotension (drop in blood pressure associated with change in position) is evident. A neuromuscular examination shows abnormal reflexes and may show severe muscle wasting (atrophy). Parkinsonian movements (tremor, rigidity, and slow movements similar to Parkinson's disease) are common.
Testing may include:
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