AUTONOMIC FAILURE IN PARKINSONS-DISEASE A ND MULTIPLE SYSTEM ATROPHY - PATHOPHYSIOLOGY, DIAGNOSTICS, THERAPY

Patients suffering from one of the different forms of multiple system atrophy (MSA) or from Parkinson's disease (PD) frequently show symptom s and signs of autonomic failure. In MSA they are caused by a predomin antly preganglionic degeneration of efferent fibers of the spinal and supraspinal part of the autonomic nervous system (ANS). in PD a predom inantly postganglionic affection of the ANS was found so far. The most important clinical symptoms include orthostatic hypotension, gastroin testinal motility disorders, urinary bladder dysfunction and sexual dy sfunction in males. The clinical relevance of these symptoms, the diag nostic and therapeutic options in daily clinical practice are discusse d.