Treatment of postprandial hypotension with acarbose in an adult with cervical spinal cord injury: a case report

Spinal Cord Series and Cases, 2023 · DOI: https://doi.org/10.1038/s41394-023-00613-2 · Published: December 1, 2023

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

Postprandial hypotension (PPH) is a drop in blood pressure after eating, possibly due to poor blood flow management related to digestion. This is often undiagnosed in spinal cord injury (SCI) patients. A 26-year-old man with a cervical SCI experienced neck pain and vision problems after meals, accompanied by a significant drop in blood pressure. He was diagnosed with PPH. Treatment with a low dose of acarbose, an alpha-glucosidase inhibitor, resolved his symptoms, allowing him to eat comfortably and gain weight.

Study Duration

1 year follow-up

Participants

A 26-year-old male with C4 ASIA A SCI

Evidence Level

Case Report

Key Findings

1
Low-dose acarbose (25mg three times daily with meals) effectively resolved postprandial hypotension symptoms in a young, non-diabetic adult with cervical SCI.
2
The patient experienced complete resolution of neck pain, vision disturbances, and blood pressure drops associated with PPH, leading to improved food intake and weight gain.
3
This case suggests that acarbose may be a beneficial treatment option for PPH in SCI patients, even at lower doses than previously reported in diabetic individuals.

Research Summary

This case report describes the successful treatment of postprandial hypotension (PPH) with acarbose in a 26-year-old male with a complete cervical spinal cord injury (SCI). The patient presented with severe neck pain, vision changes, and significant drops in blood pressure after meals. Low-dose acarbose (25 mg three times daily) led to complete resolution of symptoms and improved quality of life. The findings suggest that acarbose may be an effective treatment for PPH in SCI patients, even at lower doses than typically used in diabetic or elderly populations, and highlights the importance of recognizing and addressing PPH in individuals with SCI.

Practical Implications

Clinical Awareness

Clinicians should consider PPH as a potential cause of post-meal symptoms in SCI patients, even in younger, non-diabetic individuals.

Treatment Option

Acarbose, even at low doses, can be an effective treatment for PPH in SCI patients, improving symptoms and quality of life.

Further Research

More research is needed to understand the prevalence and optimal treatment strategies for PPH in the SCI population.

Study Limitations

1
Single case report limits generalizability.
2
Lack of a control group to confirm the efficacy of acarbose.
3
Limited understanding of the precise mechanism of acarbose in treating PPH in SCI.

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