Postural Orthostatic Tachycardia Syndrome or POTS is a form of #dysautonomia.
It used to be a rare diagnosis that often left many patients (especially women in child bearing years) left with a diagnosis of a psychiatric disorder or hysteria.
Thanks to increased awareness of the phenomenon and accessible ways to test for it at bedside, we now know it is something that is actually fairly common, especially as it presents with other illnesses.
Fundamentally, POTS is a miscommunication between the brain and the body’s organ systems. This miscommunication can happen in different ways and thus have different types of PoTS.
Most commonly, there appears to be a loss of sympathetic nerve activity to blood vessels in the legs. This causes blood to pool in the lower body, and the heart has to compensate for less blood flow by pumping faster, but less efficiently.
We now know that POtS can also be associated with low blood volume and hyperactivity of the sympathetic nervous system. Recent evidence also suggests a strong autoimmune relationship, as more PoTS patients are testing positive for various autoantibodies.
While most therapeutic approaches focus on treating peripheral findings in POts, functional Neurology has found that a rehabilitation strategy focused on central decompensation can actually help many PoTS patients get their life back.
In addition to the forms of POTS we see on paper, I think we will find greater evidence for dysfunction at the level of the Brainstem to be a major contributor to POTS physiology which allows for a dynamic rehab strategy. In fact, this rehab strategy is that different from what we do for concussed patients!
#neuroscience #neuroplasticity #POTS #fibromyalgia