Bruce H. Knox
Independent Scholar, Auckland, New Zealand
Publications
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Research Article
Walking Fails, Cycling Persists Delayed Upright Gait Dyscontrol, Recurrent Falls, and Suspected Cerebral Under- Perfusion in Multifactorial Secondary Autonomic Dysfunction
Author(s): Bruce H. Knox*
Background: Delayed orthostatic intolerance may emerge only after sustained standing or walking and can be missed by brief office measurements. Delayed orthostatic hypotension (dOH) is a haemodynamic subtype in which a qualifying blood-pressure fall occurs beyond three minutes upright; delayed orthostatic intolerance is the broader symptom phenotype. In this paper, possible cerebral under-perfusion is inferred from systemic blood-pressure readings and contemporaneous head, visual, balance, and gait symptoms; cerebral blood flow was not measured [1-5]. Case: A 74-year-old man with a history of chikungunya infection presents with multifactorial secondary autonomic dysfunction. He has consulted with both cardiology and gastroenterology specialists. His medical history includes severe arrhythmia and an ablation procedure performed in 2021, which.. Read More»