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The head and neck discomfort of autonomic failure: An unrecognized aetiology of headache

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Abstract

Information concerning the frequency, severity, character, location, duration, diurnal pattern of headache and ancillary symptoms were obtained in 25 patients with autonomic failure and 44 control subjects. Precipitating and ameliorating factors were identified. Autonomic failure patients had more head and neck discomfort than controls. Their discomfort was much more likely to localize in the occiput, nape of the neck and shoulder, compared with controls. There was a greater tendency for the discomfort to occur in the morning and after meals. It was sometimes less than 5 min in duration and was often associated with dimming, blurring, or tunnelling of vision. It was provoked by upright posture and relieved by lying down. Patients with severe autonomic failure and orthostatic hypotension often present with a posturedependent headache or neck pain. Because the relationship of these symptoms to posture is often not recognized, the fact that these findings may signal an underlying autonomic disorder is underappreciated, and the opportunity to consider this aetiology for the headache may be missed.

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Authors and Affiliations

  1. Autonomic Dysfunction Center, Departments of Medicine, Pharmacology and Neurology, Vanderbilt University, 37232-2195, Nashville, TN, USA

    David Robertson MD, Dawn Wade Kincaid RN, Virginia Haile RN & Rose Marie Robertson MD

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  1. David Robertson MD
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  2. Dawn Wade Kincaid RN
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  3. Virginia Haile RN
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  4. Rose Marie Robertson MD
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Robertson, D., Kincaid, D.W., Haile, V. et al. The head and neck discomfort of autonomic failure: An unrecognized aetiology of headache. Clinical Autonomic Research 4, 99–103 (1994). https://doi.org/10.1007/BF01845772

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  • DOI: https://doi.org/10.1007/BF01845772

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