ABSTRACT
Although Parkinson’s disease (PD) is commonly regarded as a disorder of dopamine defi ciency, it is actually a multisystem degenerative disorder. As nondopaminergic brain pathways are involved in the genesis of many symptoms, treatment is more extensive than merely increasing brain dopaminergic stimulation. The autonomic symptoms fall into this category, and management is often challenging. The autonomic features of PD affect cardiovascular function, gastrointestinal (GI) motility, urinary bladder function, sexual ability, and thermal regulation. A list of the common symptoms and signs of autonomic dysfunction is shown in Table 6.1. While symptoms of autonomic failure typically present later in the course of the disease, rare case reports exist of autonomic abnormalities as the presenting feature (1). This chapter will outline the common autonomic features of PD and discuss treatment approaches for each.
