Article

Journal of Neurology

, Volume 258, Issue 2, pp 339-345

Treatment of dysautonomia in extrapyramidal disorders

  • Tjalf ZiemssenAffiliated withAutonomic and neuroendocrinological laboratory, Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology Email author 
  • , Gerd FuchsAffiliated withParkinson Clinic
  • , Wolfgang GreulichAffiliated withNeurological clinic, HELIOS clinic Hagen-Ambrock, University Witten/Herdecke
  • , Heinz ReichmannAffiliated withMovement Disorders Research Group, Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology
  • , Michael SchwarzAffiliated withNeurological Clinic
  • , Birgit HertingAffiliated withMovement Disorders Research Group, Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of TechnologyNeurological clinic, Diakonie hospital

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Abstract

Although extrapyramidal diseases are commonly thought to solely affect the (extrapyramidal) motor system, non-motor symptoms such as behavioural abnormalities, dysautonomia, sleep disturbances and sensory dysfunctions are also frequently observed. Autonomic dysfunction is an important clinical component of extrapyramidal disease, but it is often not formally assessed, and thus frequently misdiagnosed. Symptoms of autonomic dysfunction can impact more on quality of life than motor symptoms. Appropriate symptom-oriented diagnosis and symptomatic treatment as part of an interdisciplinary approach can greatly benefit the patient. This review elaborates a limited overview on the treatment of cardiovascular, gastrointestinal, urogenital and sudomotor autonomic dysfunction in various extrapyramidal syndromes.

Keywords

Extrapyramidal disease Parkinson’s disease Autonomic dysfunction Multiple system atrophy Treatment Dysautonomia