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Wednesday, June 19, 2013
Parkinson`s and syncope
My husband went to the ED after becoming unresponsive and decreased oxygen saturation. He has parkinson`s and all his tests were negative. The physician stated that it is not uncommon for parkinson`s to cause deterioration in the autonomic nervous system that causes syncope. I had no knowledge of this and want to know more. Where can I find the information? Can you explain this?
Parkinson's disease and related syndromes such as Multiple Systems Atrophy can affect the autonomic nervous system. This is the part of the nervous system that controls such functions as blood pressure, heart rate, bladder and sexual function (among others.)
In the typical picture of PD, abnormalities in the autonomic system usually occur with more advanced disease, or if earlier, are mild (such as over active bladder and constipation). Drops in blood pressure (BP), especially when standing or changing positions (orthostatic hypotension) can be especially problematic and may occur earlier due to effects from medications used to treat PD.
If these symptoms, especially low BP spells, are prominent from the onset of the disease, this raises a question of whether or not one of the "Parkinson's syndromes" is present, rather than typical PD. Symptoms of hypotension can range from periods of confusion, tiredness and lightheadedness, to passing out (syncope). Careful review of medications is important in evaluation of this problem. Diagnostic studies such as a tilt-table test, can be done to determine if there is an inherent problem with the autonomic nervous system.
Treatment is usually conservative at first, using increased fluid intake and salt intake. Other techniques include elevating the head of the bed and wearing compression stockings. Medication is available to support blood pressure if the conservative measures do not help.
Karen M Thomas, DO
College of Medicine
The Ohio State University