Abstract
Those patients with chronic neurological diseases accidentally die during bathing. On speculation of vasomotor control disorder in those cases, we evaluated blood prssure changes at bathing in 19 cases of neuro-degenerative diseases. There were five cases of multiple system atrophy (MSA), five hereditary spinocerebellar degeneration (SCD), two cerebellar cortical atrophy, two Parkinson disease, two amyotrophic lateral sclerosis (ALS), one SMON, one Wilson disease and one multi-infarcted dementia. The blood pressure was estimated with sitting position at the time point of before bathing, five minutes in bathtub, and just after bathing. The temperature was 42 to 43 centigrade, which was routine bathtub temperature of our hospital. Three MSA, one Menzel type SCD, one Parkinson disease and one ALS showed remarkable decrease in the systolic pressure just after the bathing (more than 37 mmHg). Then, to examine the effects of temperature changes, 5 MSA and one Parkinson disease were estimated at 45 and 40 cen-tigrade, respectively. All cases showed significant decrease in the systoric pressure at 45 centigrade, and more remarkable reduction was observed in 3 MSA. One MSA showed greater decrease at 40 centigrade compared with that of at 45. There were no significant changes in other patients. Then, we conclude that the systolic pressure remarkably falls after bathing in those patients with dysautonomia, and that higher tem-perature of bathtub may cause a greater decrease. We should manage dysautonomia in taking consideration of hypotension at bathtub.
