Postural orthostatic tachycardia syndrome in a patient with relapsing-remitting optic-spinal multiple sclerosis: A case report and discussion of possible mechanism

Postural orthostatic tachycardia syndrome (POTS) is characterized by orthostatic intolerance, a presentation of autonomic dysfunction which is frequently observed in the patients with multiple sclerosis (MS). Nevertheless, to date, there have been a few studies focusing on POTS in MS patients and the underlying pathomechanism. We present a 28-year-old woman with relapsing-remitting opticspinal multiple sclerosis who also suffered POTS and discuss the possible pathomechanism of POTS in MS. Neurology Asia 2012; 17(2) : 155 – 158 Address all correspondence to: Chun-An Cheng, Department of Neurology, Tri-Service General Hospital, National Defense Medical Center. No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan, R.O.C. Tel No.: 886-287923311 ext 16875, Fax No.: 886-287927174, E-mail: cca@mail. ndmctsgh.edu.tw INTRODUCTION Postural orthostatic tachycardia syndrome (POTS) with the typical symptoms of orthostatic intolerance is a presentation of autonomic dysfunction and is presumed the result of peripheral sympathetic nerve dysfunction. Multiple sclerosis (MS) is a central nervous system demyelinating disorder with autonomic dysfunction being commonly observed. Despite the fact that orthostatic intolerance and dizziness were observed in approximately half of MS patients, there have been only few reports on POTS in MS. We present here a case of relapsing remitting MS with POTS, and discuss the possible mechanism of POTS in MS.