SHY-DRAGER SYNDROME

This paper reports the findings of 16 typical cases of Shy-Drager syndrome seen during 6 years. 81% contracted the disease after the age of 40. 15 of the 16 patients were males. Early symptoms and signs include impotence, bladder disturbance, dizziness, blurring of vision and syncopal episodes with sudden positional drops in blood pressure on changing from the recumbent to an upright position. Anhydrosis, heat intolerance, ataxia, Parkinsonism, pyramidal tract signs and muscular atrophy also occurred. Only 1 was accurately diagnosed early while the others had been misdiagnosed before admission as psychoneurosis, enlarged prostate, transient ischemic attacks, malabsorption of the small intestine, Parkinsonism, cerebellar ataxia, multiple sclerosis and amyotrophic lateral sclerosis.Treatment was largely symptomatic. Both western and herbal medications are used. Shengmaisan composed of Radix Ginseng 人参, RadixOphiopogonis麦冬and Fructus Schizandrae味子were given 13 parenterally or orally. The results of combined therapy were excellent in 2, improved in 7 and ineffective in 7 including 3 deaths. One case with autopsied findings is appended.