
Clinical orthostatic hypotension -- questions
I have some questions concerning a disease that has progressively
incapacitated my grandfather to the point that he is now more
or less confined to bed, and often unable to get up and use the
bathroom without syncope occurring.
He was recently diagnosed with Bradburry-Eggleston syndrome
and although I have been able to find references indicating
this disease (syndrome) to be a type of orthostatic hypotension
the literature does not point to what exactly "Bradbury-Eggleston"
syndrome is, and how it differentiates itself from the various
types of this disease or sometimes symptom of an
underlying illness. My first question then:
1) What type of orthostatic hypotension is Bradbury-Eggleston
syndrome?
I am also aware that the orthostatic hypotension that my grand-
father has arises from a post-ganglionic problem. As a result,
am I correct to assume that the symptoms can arise from either:
(and this is question number 2)
a) an interruption in the actual signal-delivering nerve?
b) a problem at the effector organ receptor site?
c) a problem at the effector organ (smooth muscle unable to con-
strict)?
d) a problem with the release of nor-epinephrine or its effect
in the lower area of the body?
or even a combination of some of the previous?
3) How progressive is the disease?
4) What alternative drug therapy is available or what method
of administration works best?
(presently he is on midodrine and fluodrocortisone, neither of
which seem to help a whole lot; although I can't imagine what
he would be like without them.)
5) Is there an underlying organic cause to this disease
(eg. amyloid deposit or other such ilk)?
6) And, woe is me, is it inheritable ?
I am aware this is a lot to ask so perhaps someone could at
least point me in the right direction for reference material.
Any help would be greatly appreciated.
Thank you very much.
J. Graham Pratt