Autonomic dysfunction in Parkinson's disease

Symptoms of autonomic dysfunction develop in the majority of patients with PD. The severity of autonomic symptoms is generally mild in PD patients compared with MSA patients, but the symptoms can be severely disabling in some PD patients. Evidence suggests that the neurodegeneration of PD is involved in the genesis of autonomic symptoms, but other conditions and drug side effects must be considered. Treatment of autonomic dysfunction should begin with nonpharmacologic measures and progress to pharmacotherapy in cases where symptoms remain disabling. Early recognition and management of the symptoms of autonomic dysfunction in PD patients is important for preserving QOL and reducing the risk of adverse events.