Elsevier

The Lancet

Volume 345, Issue 8950, 11 March 1995, Pages 623-624
The Lancet

Is neurally mediated hypotension an unrecognised cause of chronic fatigue?

https://doi.org/10.1016/S0140-6736(95)90525-1Get rights and content
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Abstract

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.

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