Session Information
Session Title: AA 2022 Posters - Neurological Rehabilitation
Session Time: None. Available on demand.
Disclosures: Sabrina S. Dieffenbach, MD: No financial relationships or conflicts of interest
Case Diagnosis: 26-year-old with incomplete cervical spinal cord injury (SCI)
Case Description or Program Description: Patient presented with neck pain described as severe 10/10 pain, which felt like “a rope around his neck.” Pain came on during meals and was associated with a feeling of pressure behind his eyes, white spots in his vision along with feeling as if he was going to pass out. Caregiver noted a significant drop in systolic blood pressure by about 30-40 points with meals. Additionally, the patient lost a significant amount of weight due to avoiding eating. Previous workup included multiple trips to the emergency room where he was treated with antibiotics, and intravenous fluids. Dilaudid was also tried but was ineffective for the neck pain. Working diagnosis of post-prandial hypotension (PPH) was made. Off label use of Acarbose was started due to a case report in Nature, reporting a similar finding in a SCI patient who was successfully treated with Acarbose. Acarbose was started at a low dose 25 mg three times per day with meals. During follow up patient reported a resolution of neck pain and associated symptoms with no further drops in blood pressure.
Setting: Outpatient Pediatric Physical Medicine and Rehabilitation Clinic
Assessment/Results: Patient tolerated Acarbose well and had complete resolution of neck pain and associated symptoms including severe drops in blood pressure. Patient was able to eat comfortably and subsequently gained weight.
Discussion (relevance): To our knowledge, this the second case reporting the use of Acarbose in an SCI patient for PPH and the first case showing effectiveness of lower dosing of Acarbose 25mg. It is possible many individuals with SCI experience PPH without having it properly identified and treated.
Conclusions: Clinicians should consider the possibility of PPH in SCI patients. Further research is needed on PPH, including the use of Acarbose, in the SCI population.
Level of Evidence: Level V
To cite this abstract in AMA style:
Dieffenbach SS, Shoval HA. Treatment of Postprandial Hypotension with Acarbose in an Adult with Cervical Spinal Cord Injury: A Case Report [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/treatment-of-postprandial-hypotension-with-acarbose-in-an-adult-with-cervical-spinal-cord-injury-a-case-report/. Accessed May 21, 2025.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/treatment-of-postprandial-hypotension-with-acarbose-in-an-adult-with-cervical-spinal-cord-injury-a-case-report/