madman
Super Moderator
Abstract
Recognition of the importance of nonmotor dysfunction as a component of Parkinson’s disease has exploded over the past three decades. Autonomic dysfunction is a frequent and particularly important nonmotor feature because of the broad clinical spectrum it covers. Cardiovascular, gastrointestinal, urinary, sexual, and thermoregulatory abnormalities all can appear in the setting of Parkinson’s disease. Cardiovascular dysfunction is characterized most prominently by orthostatic hypotension. Gastrointestinal dysfunction can involve virtually all levels of the gastrointestinal tract. Urinary dysfunction can entail either too frequent voiding or difficulty voiding. Sexual dysfunction is frequent and frustrating for both patient and partner. Alterations in sweating and body temperature are not widely recognized but often are present. Autonomic dysfunction can significantly and deleteriously impact the quality of life for individuals with Parkinson’s disease. Because effective treatment for many aspects of autonomic dysfunction is available, it is vitally important that assessment of autonomic dysfunction is a regular component of the neurologic history and exam and that appropriate treatment is initiated and maintained.
Conclusion
Autonomic dysfunction is a frequent, often significant, and sometimes devastating feature of PD. Although most often associated with advanced PD, autonomic dysfunction may appear early in the course of the disease and may even precede the development of the classic motor features, sometimes by years. Autonomic dysfunction can severely impact the quality of life for individuals with PD, so it is vitally important that clinicians are aware that effective treatment is available for many, though not all, aspects of autonomic dysfunction in PD. It also is important to recognize that patients often may not spontaneously mention that they are experiencing symptoms of autonomic dysfunction, either because of a failure to recognize that the symptoms are part of PD or, in some instances, because of embarrassment. Therefore, it is incumbent upon physicians to inquire regularly about the presence of autonomic symptoms during clinic visits, so that appropriate treatment can be initiated.
Recognition of the importance of nonmotor dysfunction as a component of Parkinson’s disease has exploded over the past three decades. Autonomic dysfunction is a frequent and particularly important nonmotor feature because of the broad clinical spectrum it covers. Cardiovascular, gastrointestinal, urinary, sexual, and thermoregulatory abnormalities all can appear in the setting of Parkinson’s disease. Cardiovascular dysfunction is characterized most prominently by orthostatic hypotension. Gastrointestinal dysfunction can involve virtually all levels of the gastrointestinal tract. Urinary dysfunction can entail either too frequent voiding or difficulty voiding. Sexual dysfunction is frequent and frustrating for both patient and partner. Alterations in sweating and body temperature are not widely recognized but often are present. Autonomic dysfunction can significantly and deleteriously impact the quality of life for individuals with Parkinson’s disease. Because effective treatment for many aspects of autonomic dysfunction is available, it is vitally important that assessment of autonomic dysfunction is a regular component of the neurologic history and exam and that appropriate treatment is initiated and maintained.
Conclusion
Autonomic dysfunction is a frequent, often significant, and sometimes devastating feature of PD. Although most often associated with advanced PD, autonomic dysfunction may appear early in the course of the disease and may even precede the development of the classic motor features, sometimes by years. Autonomic dysfunction can severely impact the quality of life for individuals with PD, so it is vitally important that clinicians are aware that effective treatment is available for many, though not all, aspects of autonomic dysfunction in PD. It also is important to recognize that patients often may not spontaneously mention that they are experiencing symptoms of autonomic dysfunction, either because of a failure to recognize that the symptoms are part of PD or, in some instances, because of embarrassment. Therefore, it is incumbent upon physicians to inquire regularly about the presence of autonomic symptoms during clinic visits, so that appropriate treatment can be initiated.
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