A Case Report on Multiple Sclerosis Associated With Atrial Fibrillation and Neurogenic Hypertension: Area Postrema Syndrome?

Multiple sclerosis (MS) is an autoimmune demyelinating neurological disorder primarily manifesting with a range of neurological symptoms, with cardiovascular autonomic involvement being a rare occurrence. We report a case where a patient initially presented with Bell's palsy, without other nota...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-03, Vol.16 (3), p.e55860
Main Authors: Prentice, David, Ambati, Ravi
Format: Article
Language:English
Subjects:
Antibodies
Aquaporins
Ataxia
Bells palsy
Blood pressure
Cardiac arrhythmia
Cardiology
Cardiomyopathy
Case reports
Cerebrospinal fluid
Edema
Encephalitis
Glycoproteins
Headaches
Heart rate
Hypertension
Internal Medicine
Magnetic resonance imaging
Multiple sclerosis
Nausea
Neurology
Patients
Proteins
Sinuses
Spinal cord
Vomiting
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Summary:Multiple sclerosis (MS) is an autoimmune demyelinating neurological disorder primarily manifesting with a range of neurological symptoms, with cardiovascular autonomic involvement being a rare occurrence. We report a case where a patient initially presented with Bell's palsy, without other notable symptoms or signs, and subsequently developed atrial fibrillation, hypertension, and hemiparesis. Magnetic resonance imaging (MRI) revealed extensive demyelination in the cerebral hemispheres, brainstem, and notably, the area postrema. The anatomy of the area postrema and its connections, in relation to neurogenic hypertension, are discussed. The demyelination in the area postrema was thought to be the cause of our patient's arrhythmias and acute hypertension. Furthermore, we discuss the cerebral origins of cardiac arrhythmias, with a focus on MS and other neurological conditions. This case underscores the rarity of isolated cranial neuropathies, such as Bell's palsy, as an initial sign of MS, marking the onset of a relapse.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.55860