Neepa Patel, M.D.
Movement Disorder Specialist with Henry Ford Health System Tremor, stiffness, slowness, coordination and imbalance otherwise known as motor symptoms are the most commonly recognized signs of Parkinson disease (PD). However, there is a growing recognition of the non-motor symptoms such as constipation, urinary urgency, blood pressure fluctuations and excessive sweating otherwise known as “dysautonomia” resulting is abnormal signaling within the autonomic nervous system. Symptoms of dysautonomia can be disabling and reduce quality of life (Lyons and Pahwa, 2011; Martinez-Martin et al., 2011). Up to 64% of PD patients report thermodysregulation which includes symptoms of heat and cold intolerance as well as excessive sweating (Lyons and Pahwa, 2011; Swinn et al., 2003). Excessive sweating often occurs during the “OFF” state when Parkinson’s medications are not working at their best or during a time of excessive dyskinesias (extra twisting turning movements attributed to peak effect of medication). These symptoms can be bothersome for patients and difficult to treat. Treatment is focused on reducing motor fluctuations (ie improving the time when medications are providing adequate symptom control and limiting side effects of dyskinesias). Alternation of Parkinson medications with long acting formulations of medications, continuous infusion of dopaminergic medications or implantation of deep brain stimulation may reduce these symptoms (Pursiainen et al., 2012; Sanghera et al., 2009). Other strategies for treatment may include using specific medications that reduce the activity of the autonomic nervous system or reducing sweat production. Discussion of these symptoms with you physician is recommended to determine the optimal treatment strategy for your symptoms.
Lyons, K.E., Pahwa, R., 2011. The impact and management of nonmotor symptoms of Parkinson’s disease. Am J Manag Care. 17 Suppl 12, S308-14.
Martinez-Martin, P., et al., 2011. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson’s disease. Mov Disord. 26, 399-406.
Pursiainen, V., Lyytinen, J., Pekkonen, E., 2012. Effect of duodenal levodopa infusion on blood pressure and sweating. Acta Neurol Scand. 126, e20-4.
Sanghera, M.K., et al., 2009. Alleviation of drenching sweats following subthalamic deep brain stimulation in a patient with Parkinson’s disease--a case report. J Neurol Sci. 285, 246-9.
Swinn, L., et al., 2003. Sweating dysfunction in Parkinson’s disease.
Mov Disord. 18, 1459-63