Autonomic dysfunctions in Parkinson’s disease
Urszula Fiszer
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Idiopathic Parkinson’s disease is a progressive neurological disorder, characterized by the occurrence of various movement and non-motor disturbances (olfactory, neuropsychiatric and autonomic dysfunctions). This paper discusses autonomic disturbances in Parkinson’s disease, which significantly impair patients. Autonomic dysfunctions are present already in early disease stages. They include cardiovascular, urogenital system dysfunctions, gastrointestinal, feeding, thermoregulatory disturbances, and seborrhoea. Autonomic dysfunctions in Parkinson’s disease are related to the function of parasympathetic and sympathetic system. This paper discusses the detailed clinical and neuropathological correlation, which includes scope of the autonomic functions. The research proved that disability of patients with Parkinson’s disease is mainly related to the levodopa non-responding symptoms (neuropsychiatric disturbances, falls, dysphagia, urinary dysfunction and orthostatic hypotension). These disturbances significantly worsen the patient’s life quality, and even disallow an independent functioning. In such cases there is a need to consider administration of drugs with action mechanism different than dopaminergic. There is a need to recognize the levodopa non-responding symptoms in patients with Parkinson’s disease, which may be very disturbing for the patient. A proper diagnosis of patient’s dysfunctions is very important, since sometimes an increasing levodopa treatment may have a negative impact upon patient’s condition. The paper discusses various therapy methods, based mainly upon the recommendations of the European Federation of Neurological Societies (EFNS).