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Neurally mediated hypotension
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'''Neurally mediated hypotension''' or '''NMH''' is an abnormality in regulating blood pressure experienced when the person is upright.<ref name="Bested" /> NNH causes a drop of 20β25 mm Hg in systolic blood pressure when a person is standing still compared to lying down. NMH is a form of chronic [[orthostatic intolerance]].<ref name="Bested" /> ==Signs and symptoms == Symptoms may include lightheadedness, [[dizziness]], pressure-like left-side [[chest pain]], [[visual changes]] and at times, loss of consciousness (blackouts), weakness, more pain when hit by something, [[slowed speech|slower speech]] or slowed verbal response, pallor, an immediate urge to lie down and [[syncope]] (fainting).<ref name="Bested">{{Cite journal | last = Bested | first = Alison C. | authorlink = Alison Bested | last2 = Marshall | first2 = Lynn M. | authorlink2 = | date = 2015-12-01 | title = Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians|url=https://www.degruyter.com/view/journals/reveh/30/4/article-p223.xml|journal=Reviews on Environmental Health|language=en|volume=30|issue=4|pages=223β249|doi=10.1515/reveh-2015-0026|issn=0048-7554|pmc=|pmid=|access-date=|quote=|via=}}</ref> Blood pressure readings taken lying down and when upright can be compared to assess for a drop in systolic blood pressure.<ref name="Bested" /> For example, a blood pressure of 130/85 mm Hg may change to 100/85 mm Hg when the person stands, and does not return to normal. ==Explanation == According to ''Blood Pressure Updates'', neurally mediated hypotension "is a complication that occurs due to unnatural reflex action between the brain and heart, though they are structurally normal. Neurally mediated hypotension is also called fainting reflex, or vasodepressor syncope or neurocardiogenic syncope or autonomic dysfunction or vaso-vagal reflex. Syncope is the formal medical term used for fainting."<ref>[http://www.blood-pressure-updates.com/bp/low-bp/low-blood-pressure-treatment/neurally-mediated-hypotension.htm Blood Pressure Updates - Neurally Mediated Hypotension]</ref> ==ME/CFS == Neurally mediated hypotension has been found in ME/CFS patients: *1998, Neurally mediated hypotension and chronic fatigue syndrome<ref name="Rowe, 1998">{{Citation | last1 = Rowe | first1 = PC | authorlink1 = Peter Rowe | last2 = Calkins | first2 = H | authorlink2 = | title = Neurally mediated hypotension and chronic fatigue syndrome| journal = Am J Med | volume = 105 | issue = 3A | page = 15S-21S | date = 1998 | pmid = 9790477| doi = }}</ref> *1995, The relationship between neurally mediated hypotension and the chronic fatigue syndrome<ref>{{Cite journal | last = Bou-Holaigah | first = Issam | authorlink = | last2 = Rowe | first2 = Peter C. | authorlink2 = Peter Rowe | last3 = Kan | first3 = Jean | authorlink3 = | last4 = Calkins | first4 = Hugh | authorlink4 = | authorlink5 = | date = 1995-09-27 | title = The Relationship Between Neurally Mediated Hypotension and the Chronic Fatigue Syndrome|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1995.03530120053041|journal=JAMA: The Journal of the American Medical Association|language=en|volume=274|issue=12 | pages = 961|doi=10.1001/jama.1995.03530120053041|issn=0098-7484|quote=|via=}}</ref> == See also == *[[Orthostatic intolerance]] (OI) *[[Postural orthostatic tachycardia syndrome]] (POTS) *[[Autonomic nervous system]] *[[Dizziness]] *[[Hypotension]] *[[Tilt table test]] ==Learn more== *[https://theoicenter.com/About-OI/What-is-NMH.html What is Neurally Mediated Hypotension?] - The Orthostatic Intolerance Center ==References == {{Reflist}} [[Category:Diagnoses]] [[Category:Potential comorbidities]] [[Category:Signs and symptoms]] [[Category:Cardiac signs and symptoms]] [[Category:Neurological signs and symptoms]] [[Category:Autonomic nervous system disorders]] [[Category:Energy production or transportation symptoms]]
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