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Volume 343:581 August 24, 2000 Number 8
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Munchausen's Syndrome Presenting as Baroreflex Failure

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To the Editor: Baroreflex failure is characterized by episodes of severe hypertension and tachycardia,1 alternating with episodes of normal or even low blood pressure and bradycardia.2 It is often caused by interruption of the baroreflex arch as a result of bilateral damage to the glossopharyngeal and vagus nerves from trauma, radiation, or surgery. Less often, the lesion is in the brain stem,3 and in some cases, the primary cause is not found.

A 68-year-old woman was referred for evaluation of baroreflex failure because of a four-year history of severe episodes of hypertension (systolic blood pressure >200 mm Hg for two . . . [Full Text of this Article]

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