19th Meeting of the European Neurological Society (ENS)

ENS 2009: First Signs of Parkinson's Often Not Motor-Related

Allison Gandey
http://www.medscape.com/viewarticle/705177?src=rss

July 1, 2009 (Milan, Italy) — Patients may have symptoms years before they experience the motor manifestations of Parkinson's disease, report experts. Presenting here at the 19th Meeting of the European Neurological Society, researchers emphasized that an array of seemingly unrelated symptoms may actually be the first signs of Parkinson's.

"Evidence is accumulating from clinical, neuroimaging, and pathological studies that olfactory dysfunction, dysautonomia, or mood and sleep disorders can occur years and perhaps even decades before the classical motor symptoms arise," Eduardo Tolosa, MD, from the University of Barcelona, in Spain, said at the meeting.

I was profusely sweating many years before my first motor symptom. Can't think of anything else at this moment.

"Parkinson's disease patients also find great difficulty in managing sweat and saliva, often attributed to lack of bodily temperature control. Unlike orthostatic hypotension, which can occur at any stage of Parkinson's disease, the frequency and severity of sweating is directly related to the progression of the disease. It is believed the increased sweating, often quite profuse, can be directly related to progressive neurodegeneration of the central nervous system."

Sweating

As with problems of bowel and bladder, impotence, and blood pressure, sweating in PD may result from disturbances in the part of the nervous system (autonomic nervous system) that control these autonomic functions. Disorders of the autonomic nervous system are called dysautonomia. When dysautonomia is acute, we may be dealing with one of the atypical parkinsonisms called Shy-Drager syndrome. Still, dysautonomia is compatible with a diagnosis of PD, and abnormalities of sweating, particularly excessive sweating, is not uncommon in PD. It frequently involves the upper part of the body more than the lower, and may be a sign of untreated or undertreated parkinsonism. Profuse, drenching sweats may occur infrequently but may be very bothersome, and may be associated with the wearing - off of medication in the advanced patient."