[Autonomic disturbances in Parkinson's disease and their treatment]

Disturbances of autonomic functions are, without a doubt, part of the symptomatology of Parkinson's disease, but do have little importance as initial symptoms. They are more prominent in the advanced stages of the disease, when they then have an impact on the kind of patients' complaints and on the effects of the therapeutic measures. For example, pollakisuria and urge incontinence are restrictive for social activities and, simultaneously, nighttime akinesia disturbs sleep and recovery. Dysfunction of gastrointestinal mobility brings about a retardation in drug transport from the stomach to the upper intestine and thereby in drug absorption with the sequel of an inadequate response of the parkinsonian symptomatology. Detailed registration--there is a large number of methods--of autonomic functions provides insight into the extent of the degenerative process, but mainly helps to find ways to improve the resulting dysfunctions. Whereas some signs like thermoregulation, sebaceous secretion and sleep disturbances caused by night-time akinesia do improve under drug treatment, others like cardiovascular dysregulation and delayed colon transit-time may even be worsened.