1. Urogenital symptoms in Parkinson's disease and multiple system atrophy-Parkinsonism: at onset and later.
- Author
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Swaminath PV, Ragothaman M, Koshy S, Sarangmath N, Adhyam M, Subbakrishna DK, Mathias CJ, and Muthane UB
- Subjects
- Adult, Age of Onset, Aged, Aged, 80 and over, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Multiple System Atrophy diagnosis, Multiple System Atrophy physiopathology, Parkinsonian Disorders diagnosis, Parkinsonian Disorders physiopathology, Prospective Studies, Urinary Bladder Diseases physiopathology, Urination Disorders physiopathology, Urodynamics, Multiple System Atrophy complications, Parkinsonian Disorders complications, Sexual Dysfunction, Physiological etiology, Urinary Bladder Diseases etiology, Urination Disorders etiology
- Abstract
Methods: One hundred and eighty-one parkinsonian patients were evaluated to determine if urogenital symptoms at presentation to the Neurology clinic can differentiate them as PD or MSA-P. An autonomic questionnaire was used to document urinary and genital symptoms., Results: Mean age at presentation and disease duration in PD and MSA-P were similar. Urinary symptoms occurred twice as frequently in MSA-P than in PD. Storage symptoms (frequency, urgency, urge incontinence, nocturia) were common in both Parkinsonian disorders. Male MSA-P reported genital symptoms (erectile and ejaculatory failure) three times more frequently than in PD., Conclusions: Urogenital symptoms occurred in MSA-P when they had mild motor few symptoms unlike in PD where they occur when motor symptoms were severe. Urogenital dysfunction occurred early and was present in all MSA-P patients within two years. Presence of urogenital symptoms in early stages of Parkinsonism strongly favors MSA-P rather than PD. Absence of urogenital symptoms in advanced Parkinsonism makes MSA-P unlikely.
- Published
- 2010