RESEARCH: Autonomic dysfunction in movement disorders.

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Curr Opin Neurol 2001 Aug;14(4):505-11

Autonomic dysfunction in movement disorders.

Chaudhuri KR.

Regional Movement Disorders and Autonomic Unit, Department of Neurology,

King's College Hospital, London, UK. ray.chaudhuri@...

Dysfunction of the autonomic nervous system is an under-recognised but

important aspect of the aetiological and clinical manifestation of primary

degenerative dysautonomias such as multiple system atrophy (MSA) and

Parkinson's disease (PD). Although the clinical presentation of dysautonomia

in these two disorders may overlap, yet pathological and in vivo imaging

studies suggest considerable differences. Functional imaging studies suggest

that selective cardiac sympathetic denervation may occur early in PD but not

in other parkinsonian syndromes. The clinical implication of this apparently

disease specific peripheral dysautonomia is unknown and would be the subject

of much interest in future years. Dysautonomia in degenerative disorders

also affect respiration, genitourinary function and sleep. Sleep related

disorders such as rapid eye movement behaviour disorder and urinary voiding

dysfunction appear to precede the development of PD related symptoms while

patients with sporadic ataxia have been shown to progress to develop MSA.

Dysautonomia has also been recognised in other movement disorders, examples

being the combination of dystonia and complex regional pain syndrome with

elevated HLA-DR13 and late onset Huntington's disease presenting with

dominant parkinsonism and minimal chorea. These studies have helped progress

in various diagnostic and management parameters in relation to autonomic

dysfunction and movement disorders.

Publication Types:

Review

Review, Tutorial

PMID: 11470968 [PubMed - indexed for MEDLINE]