Autonomic involvement in extrapyramidal and cerebellar disorders

Paola Sandroni, J. Eric Ahlskog, Robert D. Fealey, Phillip Anson Low

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

We reviewed the clinical and autonomic features of all patients with extrapyramidal and cerebellar disorders studied in the Mayo Autonomic Reflex Laboratory from 1983 to 1989. Patients were grouped into the following categories (number in parentheses): Parkinson's disease (35); parkinsonism-plus (54); multiple system atrophy (75); hereditary multisystem degenerations (eleven); progressive supranuclear palsy (32); non-familial cerebellar degeneration (eleven); nonspecific sporadic multisystem degeneration (73). Severe autonomic failure occurred in 97% of patients with multiple system atrophy and 53% of the nonspecific sporadic multisystem degeneration patients respectively. Autonomic involvement was mild or absent in Parkinson's disease while parkinsonism-plus and non-familial cerebellar degeneration patients had moderate autonomic failure. Orthostatic blood pressure reduction, percentage of anhidrosis on thermoregulatory sweat test, quantitative sudomotor axon reflex test, forearm response and heart rate response to deep breathing strongly regressed with severity. A response to levodopa treatment in patients with parkinsonism was more likely if cerebellar signs and cognitive deficits were absent. The presence of levodopa induced dyskinesia was also a marker for a clinically favourable levodopa response. We conclude that there is a spectrum of autonomic involvement in these degenerative disorders and that autonomic studies are useful in separating them and monitoring their course.

Original languageEnglish (US)
Pages (from-to)147-155
Number of pages9
JournalClinical Autonomic Research
Volume1
Issue number2
DOIs
StatePublished - Jun 1991

Fingerprint

Basal Ganglia Diseases
Cerebellar Diseases
Parkinsonian Disorders
Levodopa
Multiple System Atrophy
Parkinson Disease
Reflex
Hypohidrosis
Progressive Supranuclear Palsy
Sweat
Dyskinesias
Forearm
Axons
Respiration
Heart Rate
Blood Pressure

Keywords

  • Autonomic failure
  • Cerebellar degeneration
  • Multiple system atrophy
  • Parkinsonism

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Autonomic involvement in extrapyramidal and cerebellar disorders. / Sandroni, Paola; Ahlskog, J. Eric; Fealey, Robert D.; Low, Phillip Anson.

In: Clinical Autonomic Research, Vol. 1, No. 2, 06.1991, p. 147-155.

Research output: Contribution to journalArticle

Sandroni, Paola ; Ahlskog, J. Eric ; Fealey, Robert D. ; Low, Phillip Anson. / Autonomic involvement in extrapyramidal and cerebellar disorders. In: Clinical Autonomic Research. 1991 ; Vol. 1, No. 2. pp. 147-155.
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