Shy-Drager syndrome

Alternative names:

neurologic orthostatic hypotension; Shy-McGee-Drager syndrome

Treatment:

There is no cure for the disorder and no known means to slow progression. The treatment is aimed at controlling symptoms such as postural hypotension and parkinsonian movements.

Amantadine and/or anticholinergic medications may be used to reduce early or mild tremors. Levodopa may improve movement and balance.
Carbidopa may reduce the side effects of Levodopa and make the Levodopa work better. The response to medications may be disappointing. Many affected individuals respond poorly to treatment with anticholinergics or Levodopa.

Sympathomimetics, vasoconstrictors, beta-blockers, MAO inhibitors, vasopressin, 9-fluohydrocortisone, or other medications may be used to treat low blood pressure (postural hypotension).

A heart pacemaker programmed to stimulate the heart to beat at a rapid rate (faster than 100) may increase the blood pressure for some people.

Expectations (prognosis):

The probable outcome is poor. There is a progressive loss of mental and physical functions until general debilitation develops. Early death is likely.

Complications:

• progressive loss of ability to walk or care for self
• difficulty performing daily activities
• injuries from falls/fainting
• side effects of medications

Calling your health care provider:

Call your health care provider if symptoms of Shy-Drager syndrome recur, worsen, or progress.

Call your health care provider if new symptoms appear, including possible side effects of medications: involuntary movements, nausea/vomiting, dizziness, changes in alertness/behavior/mood, severe confusion or disorientation, delusional behavior, hallucinations, loss of mental functioning, or any other new symptoms that develop (see also the specific medication).

Also, consult with your health care provider if the condition of a family member with this disorder deteriorates and you are unable to care for the person at home.