Autonomic dysfunction in patients with Parkinson´s disease
Parkinson’s disease is classically recognised by rest tremor, bradikinesia and rigidity. However many patients present with a group of non-motor symptoms which, due to the appearance of the classical symptoms or their low specificity, are not recognised as a part of the disease. These symptoms can include heart conditions related to sympathetic denervation, or gastrointestinal disorders such as constipation and sialorrhoea, urinary and sexual dysfunction, and conditions affecting blood pressure specifically manifested as orthostatic hypotension. Hypotension is defined as a reduction of 20 mmHg in systolic arterial pressure or 10 mmHg in diastolic pressure during the first 3 minutes after adopting a standing position. Another problem is the presence of supine hypertension which occasionally appears independently of the hypotension or coexists in the same patient. This makes it difficult to establish an adequate treatment as the effective measures for supine hypertension could worsen hypotension, while the response to drugs in the latter is not standard as yet, and varies according to the individual.
- Miguel Ángel Imízcoz. Cardiologist
- Rosa Larumbe and Pedro Clavero (reviewers). Neurologists. Navarre Hospital Complex