Autonomic Dysfunction in Parkinson's Disease

Parkinson’s disease (PD) is usually described by the motor symptoms; however, non-motor symptoms, including symptoms of autonomic dysfunction are being increasingly identified in PD over the last two decades, causing major disability to the patient. Despite this, majority of patients and clinicians emphasize the motor symptoms of PD, leading to underreporting and under recognition of autonomic dysfunction in PD. Autonomic dysfunctions are quite common in PD and being reported in approximately 90% of PD patients during their life. 1 Autonomic dysfunctions are associated with significantly impaired quality of life (QOL) and increased mortality in PD. 1 , 2 Timely recognition and proper management of autonomic dysfunctions can improve the QOL in patients with PD. This chapter will discuss the frequency, pathophysiology, symptoms and management of various autonomic dysfunctions encountered in PD ( Box 1 ).