Case 98: Repetitive Psychogenic Pseudosyncope

Cerebral blood flow velocity monitoring can be useful to diagnose psychogenic pseudosyncope.

Case 73: Dysautonomia Due to Mast Cell Activation Syndrome or Psoriatic Arthritis?

The patient presents with fatigue, postprandial nausea, diarrhea, food allergies, and nighttime tachycardia. She was diagnosed with mast cell syndrome (MCAS). Autonomic testing has shown anxiety; mild postural tachycardia syndrome (POTS), neuropathic form; and small fiber neuropathy, mixed, length-dependent.

Case 70: Small Fiber Neuropathy and Generalized Hypermobility Spectrum Disorder

Autonomic testing showed mixed small fiber neuropathy, which can be responsible for both sensory complaints and dysautonomia. Dysautonomia was generalized but mild. The patient has generalized hypermobility spectrum disorder (GHSD).

Case 67: Ehlers-Danlos Syndrome with Postural Tachycardia Syndrome and Psychogenic Pseudosyncope

Patient became unresponsive during the first minute of the tilt; she was tachycardic but the blood pressure and cerebral blood flow were stable. Psychogenic pseudosyncope can be superimposed on postural tachycardia syndrome (POTS). Pseudosyncope, small fiber neuropathy, and POTS can be associated with hypermobile Ehlers-Danlos syndrome.

Case 65: Ehlers-Danlos Syndrome with Postural Tachycardia Syndrome, Presyncope, and Anxiety

The tilt test showed a combination of anxiety, postural tachycardia syndrome (POTS), and presyncope. The POTS in this patient was mild, but anxiety may exacerbate symptoms.

Case 60: Small Fiber Neuropathy, Seronegative, Treated with Immune Globulins

Small fiber neuropathy, mixed, length-dependent can be autoimmune even if no antineuronal antibodies can be found. Yet the seronegative small fiber neuropathy may still respond to therapy with immune globulins.

Case 58: Small Fiber Neuropathy and Orthostatic Cerebral Hypoperfusion Syndrome with Positive Autoantibodies to N-type Calcium Channel

Small fiber neuropathy, mixed, length-dependent, is associated with antibodies against the N-type calcium channel. Tilt showed hypocapnic cerebral hypoperfusion.

Case 55: Small Fiber Neuropathy with Autonomic Failure

This case demonstrates severe autonomic failure with orthostatic hypotension affecting cardiovagal and sympathetic adrenergic fibers and associated with small fiber neuropathy. Small fiber neuropathy is severe, mixed, and affecting sensory and autonomic fibers, non–length-dependent. Orthostatic cerebral blood flow velocity was reduced throughout the tilt, indicative of autoregulation failure.

Case 53: Small Fiber Neuropathy with Striational Antibodies

This case describes neuropathic postural tachycardia syndrome (POTS) with striational antibodies that can be associated with small fiber neuropathy and respond to IVIG.

Case 51: Small Fiber Neuropathy and Transient Orthostatic Hypotension in Diabetes

This patient is an example of a typical autonomic failure associated with diabetes mellitus. Autonomic testing showed generalized autonomic failure with orthostatic hypotension and severe small fiber neuropathy affecting both sensory and autonomic fibers.