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Advanced Neurology POTS with autonomic storms misdiagnosed as FND

as well as myoclonic episodes, performing a tilt table Consent for publication
test may help to define and properly identify POTS to
optimize management. The diagnosis can be reinforced by Consent for publication was obtained from all patients.
multiple heart rate and blood rate measurements, which Availability of data
can be conducted at home by patients, for a duration of
approximately 3 – 6 months. 17 Not applicable.
There are several limitations to our study. First, the References
case series review was conducted with a small sample 1. Benarroch EE. Postural tachycardia syndrome: A
size, resulting in limited statistical power and precision. heterogeneous and multifactorial disorder. Mayo Clin Proc.
Second, our data included patient questionnaires, including 2012;87(12):1214-1225.
subjective responses which may have been influenced by
personal beliefs and assumptions. Despite these limitations, doi: 10.1016/j.mayocp.2012.08.013
our study indicates that myoclonus is a symptom of POTS, 2. Landero J. Postural orthostatic tachycardia syndrome: A
and it should be seen as such to effectively decrease the time dermatologic perspective and successful treatment with
it takes for a patient to be correctly diagnosed and treated. losartan. J Clin Aesthet Dermatol. 2014;7(8):41-47.
3. Lemke DM. Riding out the storm: Sympathetic storming
4. Conclusion after traumatic brain injury. J Neurosci Nurs. 2004;36(1):4-9.
Due to its complex variety of symptoms and frequently 4. Termsarasab P, Frucht SJ. Dystonic storm: A practical
associated comorbidities, POTS-affected patients are often clinical and video review. J Clin Mov Disord. 2017;4:10.
misdiagnosed with psychological disorders, including doi: 10.1186/s40734-017-0057-z
FND. Considering the debilitating effects of POTS, our
case series highlights the importance of performing a 5. Zadourian A, Doherty TA, Swiatkiewicz I, Taub PR.
timely and accurate diagnosis of this condition. This can Postural orthostatic tachycardia syndrome:
be facilitated by carefully recording the medical histories Prevalence, pathophysiology, and management. Drugs
of patients who present with orthostatic symptoms and 2018;78(10):983-994.
myoclonus, followed by tilt table testing. More clinical doi: 10.1007/s40265-018-0931-5
research is necessary to prevent neurological symptoms 6. Goodman BP. Evaluation of postural tachycardia syndrome
from being misattributed to psychological disorders, as (POTS). Auton Neurosci. 2018;215(12):12-19.
more accurate diagnostics will improve clinical outcomes.
doi: 10.1016/j.autneu.2018.04.004
Acknowledgments 7. Walzl D, Solomon AJ, Stone J. Functional neurological
disorder and multiple sclerosis: A systematic review
None.
of misdiagnosis and clinical overlap. J Neurol.
Funding 2022;269(2):654-663.
doi: 10.1007/s00415-021-10436-6
None.
8. Safwat S, Safwat F, Sivanathan N, Daka N, Sadek M.
Conflict of interest Misdiagnosed seizure-like activity in a patient with postural
orthostatic tachycardia syndrome: A case report. Cureus
The authors declare that they have no competing interests. 2023;15(5):e39565.

Author contributions doi: 10.7759/cureus.39565
Conceptualization: Anna D. Hohler 9. Van der Feltz-Cornelis M, Allen SF,
Formal analysis: All authors Van Eck van der Sluijs JF. Misdiagnosis of an underlying
Investigation: All authors medical condition as Conversion Disorder/Functional
Neurological Disorder (CD/FND) still occurs. Gen Hos
Writing – original draft: Anna D. Hohler Psychiatry. 2020;65:43-46.
Writing – review & editing: All authors
doi: 10.1016/j.genhosppsych.2020.05.003
Ethics approval and consent to participate 10. Berry AJ, Wiethoff S. Revising a diagnosis of functional
This case series received exemption from the Institutional neurological disorder-a case report. Oxf Med Case Reports.
Review Board. Informed written consent for publication 2020;2020(9):omaa073.
was obtained from all patients. doi: 10.1093/omcr/omaa073

Volume 4 Issue 2 (2025) 126 doi: 10.36922/an.7653