ORTHOSTATIC HYPOTENSION IN IDIOPATHIC PARKINSONS DISEASE

Abstract

ABSTRACT Parkinsons disease has been
viewed traditionally as a motor disorder
characterized by the cardinal features resting
tremor, bradykinesia, rigidity and postural
instability. But several non motor
symptoms like autonomic dysfunction,
sensory disturbances, behavioral, cognitive
problems and sleep disorders may
also occupy the disease spectrum. The
non-motor symptoms continue to be poorly
diagnosed and inadequately treated in
contrast to the motor symptoms. AIM OBJECTIVES
(i) To diagnose orthostatic hypotension
in idiopathic Parkinsons disease
patients and to insist the need for appropriate
management in order to improve their
quality of life. (ii) To compare the orthostatic
fall in blood pressure between
idiopathic Parkinsons disease patients and
normal subjects. MATERIALS AND
METHODS 30 patients with the clinical diagnosis
of idiopathic Parkinsons disease
based on the United Kingdom Parkinsons
Disease Society Brain Bank Clinical Diagnostic
Criteria were included in the study
group. Disease staging was done using
the Hoehn and Yahr staging system.
Corresponding age matched normal subjects
were taken as control group. The
mercury sphygmomanometer with standard
adult size cuff was used to record
the blood pressure after a 15 minutes rest
at supine position and within 3 minutes
after standing. RESULTS 17 patients
were found to have orthostatic hypotension.
Among them, 7 patients were asymptomatic.
There was a significantly (P
value 0.001) greater fall in the systolic and
diastolic blood pressures from supine to
standing posture in the patients group
when compared to the controls. CONCLUSION
Several drugs are being used
for OH, but there efficacy is not proved so
far. Hence non pharmacological methods
should be advised to the patients. To prevent
the potential trauma due to falls OH
should be diagnosed earlier and managed
appropriately.