RT Journal A1 Boylan LS T1 MUtual influences between paroxysmal hypertension and psychiatric disturbance JF Archives of Internal Medicine JO Archives of Internal Medicine YR 1999 FD September 27 VO 159 IS 17 SP 2091 OP 2092 DO UL http://dx.doi.org/ AB In a recent issue of the ARCHIVES, Dr Mann provided evidence for a psychiatric origin of some cases of paroxysmal hypertension.1 Herein, I describe a woman whose symptoms of paroxysmal despair were likely related to extreme blood pressure fluctuation in the setting of idiopathic dysautonomia.