Autonomic nervous system screening in patients with early Parkinson’s disease
Clinical autonomic dysfunction is rarely a problem in the initial presentation of patients with Parkinson’s disease, with the notable exception of constipation. Rather, the existence of definite and conspicuous manifestations should be an important indication that the underlying disease producing the extrapyramidal features is multi-system atrophy rather than Parkinson’s disease. The frequent occurrence of constipation may be suggestive of Parkinson’s disease, but a more detailed analysis as to the underlying mechanisms and characteristics which may possibly distinguish this from the common constipation of old age remain to be established. Furthermore, it will be of importance to look systematically for Lewy bodies in autonomic ganglia since these peripheral structures may provide tissue diagnosis, so much desired in this disease.
KeywordsOrthostatic Hypotension Ergot Alkaloid Optic Nerve Disease Extrapyramidal Feature Autonomic Manifestation
Unable to display preview. Download preview PDF.
- Appenzeller O, Gross JE, Albuquerque NM (1971) Autonomic deficits in Parkinson’s syndrome. Arch Neurol 24: 30–57Google Scholar
- Blumen SC, Feiler-Ofry V, Korczyn AD (1986) The pupil cycle time in Homer’s syndrome. J Clin Neuro Ophthalmol 6: 232–234Google Scholar
- Korczyn AD, Rubenstein AE (1982) Autonomic nervous system complications of therapy. In: Silverstein A (ed) Neurological complications of therapy. Futura, New York, pp 405–418Google Scholar
- Korczyn AD, Rubenstein AE, Yahr MD (1985) The pupil in Parkinson’s disease. Proc, 8th international symposium on Parkinson’s disease, New York, 1985, pp 43Google Scholar
- Korczyn AD (1987) Autonomic manifestations in Parkinson’s disease. In: Nappi G, Caraceni T (eds) Morbo di parkinson e malattie extrapiramidali. Edizioni Mediche Italiane, Pavia, pp 201–205Google Scholar
- Kreek JJ, Schaefer RA, Hahn EF, Fishman J (1983) Naloxone, a specific opioid antagonist reverses chronic idiopathic constipation. Lancet is 261–262Google Scholar
- Miller SD, Thompson HS (1978 b) Pupil cycle time in optic neuritis. Am J Ophthalmol 85: 635–642Google Scholar
- Rabey JM, Treves T, Streifler M, Korczyn AD (1986) Comparison of efficacy of lisuride hydrogen maleate with increased doses of levodopa in Parkinsonian patients. Adv Neurol 45: 569–572Google Scholar
- Rajput AH, Rozdilsky B (1976) Dysautonomia in parkinsonism: A clinicopathological study. J Neurol Neurosurg Psychiatr 39: 1092–1100Google Scholar