The idiopathic orthostatic hypotension can be characterized as a presenile degenerative process with a liability to attack especially multiple systems. In the course of the disease clinically the autonomic functional failure stands in the beginning. It also determines the serious illness in the later stages, which is associated with an additional variable neurologic syndrome. By means of an own clinically and pathologically examined case it is given a survey of the present knowledge about the disease process. Especially it is declared on the localization of the lesions. Phaemacological tests point to a main disturbance of the preganglionic respectively central part of the sympathetic system. The analysis of the neuropathologically examined cases shows as the most regular finding a neuronal loss in the nucleus intermediolateralis, which certainly is hold responsible for a great part of the functional failure. But it is to assume, that lesions in other structures cooperate in the genesis of the syndrome, which morphologically are not yet recorded.

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