Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a group of patients suffering from Parkinson's disease, beside neurogenic bladder dysfunction, we have also found dysfunction affecting the external sphincter musculature. Treatment with L-Dopa probably improves the urethral symptoms by providing a relaxing effect on the urethral closure pressur together with better coordination of the pelvic floor and external sphincter Mechanism during micturition. The effect was parallel to the improvement in Parkinsonion symptoms. Experimental studies demonstrate the ability of L-Dopa to reduce urethral closure pressure and this effect was related to a central effect on the skeletal musculature.
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PMID:Parkinsonism and neurogenic bladder. Experimental and clinical observations. 103 92

Fifty five patients between 65 and 89 years old who had their urinary problems assessed by urodynamics study were reviewed. The most common urinary symptom among males was urge incontinence, while retention and urge incontinence occurred with equal frequency among females. The commonest cause of retention in males was bladder outlet obstruction, while atonic neurogenic bladder was the most common cause in females. Urge incontinence was strongly associated with an unstable bladder, small bladder volume and Parkinson's disease. Retention of urine, and an atonic neurogenic bladder strongly correlated with diabetes mellitus. Three patients (out of 31) with unstable bladders also had detrusor external sphincter dyssynergia. Of these, two had Parkinson's disease. Although three patients were thought to have stress incontinence after history and physical examination, only two had stress incontinence with detrusor instability on urodynamic studies. The last patient had atonic bladder with overflow.
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PMID:Urinary symptoms and urodynamic diagnosis of patients in one geriatric department. 129 23

Neurogenic bladder frequently occurs in Parkinson's disease. Detrusor hyperreflexia is a consequence of nigrostriatal dopamine depletion whereas mechanism of hyporeflexia remains unclear. We compared the results of cystometry and urethral profilometry with and without apomorphine (and L dopa) in 12 idiopathic parkinsonians with urinary disorders off dopaminergic treatment. Hyperreflexic patients improved with apomorphine and to a lesser extent with L dopa, whereas these drugs had no effect on hyperreflexic patients. These results confirm the role of dopaminergic lesions in the occurrence of bladder hyperreflexia and the possible action of non dopaminergic lesions in the occurrence of hyporeflexia.
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PMID:[Effect of apomorphine on the bladder of parkinsonian patients]. 152 94

Autonomic failure with Lewy bodies (AF-LB) was first described by Fichefet et al. in 1965, and more than ten cases have been reported to date. AF-LB and Parkinson's disease (PD) share the neuropathological findings characterized by widely distributed Lewy bodies in the central nervous system including the substantia nigra and locus coeruleus. However, clinical manifestations of AF-LB are far different from PD in which autonomic dysfunction, if present, is not a predominant feature. In the present study, clinical features were comparatively analysed in AF-LB and PD to investigate the nosological relation between PD and AF-LB. The subjects were 94 patients with PD and 11 reported cases of AF-LB in the literature. A test of 70 degrees passive head-up tilt was performed upon the patients with PD in our laboratory. Based on the results in tilting test, the patients with PD were divided into two groups; PD-I (69 cases) with an orthostatic fall of systolic blood pressure less than 30 mmHg, and PD-II (25 cases) with a fall of 30 mmHg or more. Autonomic dysfunctions were more extent in PD-II than in PD-I, because the incidences of anhidrosis, impotence, neurogenic bladder and constipation were higher in PD-II. All of the cases of AF-LB were contained in the previous literatures with reasonably full clinical descriptions. Mean age at onset of the disease was 62.1 +/- 8.7 (mean +/- SD) years old in PD-I, 64.5 +/- 7.5 years old in PD-II and 63.9 +/- 9.0 years old in AF-LB, and no significant differences were found among the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Nosological correlation between autonomic failure with Lewy bodies and Parkinson's disease--comparative assessment of clinical features in both diseases]. 208 26

Metoclopramide, a dopamine antagonist, is approved in the U.S. for the treatment of various gastrointestinal disorders. Its use has been investigated in a wide variety of diseases, including those not involving the intestinal tract. Although more study is required before routine clinical use of metoclopramide can be advocated, it may be effective in the treatment of tardive dyskinesia, in decreasing the risk factors associated with anesthetic-related aspiration, and as an adjunct in the treatment of gastric bezoars. It also may be used safely in patients with Parkinson's disease. The use of metoclopramide in the treatment of neurogenic bladder, orthostatic hypotension, tumor-associated gastroparesis, nonprolactinemic amenorrhea, failure to thrive, Tourette's syndrome, anorexia nervosa, and hiccups, as well as an adjunct to migraine therapy, has been investigated, but sufficient evidence has not been accumulated to advocate the use of metoclopramide in these disorders.
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PMID:Potential uses for metoclopramide. 390 32

Shy-Drager syndrome consists of progressive autonomic nervous system failure with Parkinson's disease-like symptoms and orthostatic hypotension. It can also result in airway compromise from bilateral vocal cord paralysis. Fewer than 30 cases of severe bilateral vocal cord paresis or paralysis associated with the Shy-Drager syndrome have been reported in the English literature. We present a case of a 72-year-old man who had a 2-year history of orthostatic hypotension, neurogenic bladder, impotence, anhydrosis, and extremity weakness and paresthesias. Hoarseness and dyspnea with stridor developed as a result of bilateral vocal cord paralysis in the median position and required an emergency tracheotomy. This combination of symptoms resulted in the diagnosis of Shy-Drager syndrome. We present the case along with literature review of bilateral vocal cord paralysis with the Shy-Drager syndrome.
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PMID:Bilateral vocal cord paralysis with Shy-Drager syndrome. 750 34

Neurogenic bladder is a common feature in many neurological disorders such as stroke, multiple sclerosis, paraplegia, Parkinson disease, peripheral neuropathy. Specific treatment is always necessary to improve quality of life and decrease renal potential risk. Urodynamic investigations (cystometry, pelvic floor electromyography) are very useful to determine physiopathologic mechanisms of bladder dysfunction.
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PMID:[Vesico-sphincter disorders of nervous origin]. 772 38

Neurogenic bladder frequently occurs in Parkinson's disease. Detrusor hyperreflexia is a consequence of nigrostriatal dopamine depletion, whereas the cause of hyporeflexia remains unclear. We compared the results of cystometry and urethral profilometry with and without apomorphine (and L dopa) in 12 idiopathic parkinsonians with urinary disorders free of dopaminergic treatment. Whereas hyperreflexic patients improved with apomorphine, and to a lesser extent with L dopa, these drugs had no effect on hyporeflexic patients. These results confirm the role of dopaminergic lesions in the occurrence of bladder hyperreflexia and the possible implication of nondopaminergic lesions in the occurrence of hyporeflexia.
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PMID:Effects of apomorphine and L-dopa on the parkinsonian bladder. 833 43

A case of familial juvenile parkinsonism with dementia, orthostatic hypotension, neurogenic bladder and constipation was reported. He had been in a good health until the age of 28 when a finger tremor occurred on effort to hold hands in a definite position, and disturbances in gait and speech were noted. These symptoms were relieved by levodopa treatment followed by dyskinesia and motor fluctuations. Three years later, he complained of faintness, constipation and urinary frequency. The neurological examination revealed mentally sound male with masked face, tremor and rigidity in his extremities, and short step gait with lateropulsion. Urodynamic study showed uninhibited bladder. In the following years, orthostatic hypotension, dysuria and urinary retention developed gradually. He became mentally loose and was unable to take medicines appropriately. When in the Nishiojiya Byoin National Sanatorium, he tried to snake out the hospital many times. His parents and a brother suffered from Parkinson's disease and juvenile parkinsonism, respectively, suggesting an autosomal dominant inheritance. On admission to our hospital, he was apathetic. He had masked face, bilateral postural tremor, frozen gait and dyskinesia in the right lower extremity. Little bradykinesia or rigidity was noted. His muscle tone and deep tendon reflexes were decreased but neither muscular wasting, weakness, ataxia nor sensory disturbance was observed. Laboratory data including ceruloplasmin, copper, dopamine-beta-hydroxylase and lysosomal enzyme activities were normal except for mild anemia. A cranial CT scan revealed mild cortical atrophy in the frontal and temporal lobes, but nerve conduction study and cortical evoked potentials showed no abnormality. While in the hospital, his mental functions deteriorated to the state of dementia and orthostatic hypotension became apparent.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Familial juvenile parkinsonism with dementia and autonomic failure--a case report]. 833 79

Neurologic disorders create important functional urinary tract abnormalities. Loss of bladder reflex inhibition and coordination due to neurologic disease or injury to higher centers may lead to morbidity such as recurrent urinary tract infection, hydronephrosis, urinary tract stones and loss of renal function. This paper discusses neurogenic bladder disease using a descriptive urodynamic format. The importance of detrusor hyperreflexia and internal and external sphincter dyssynergia are discussed in detail. Finally, a practical clinical management plan is discussed for patients with urologic dysfunction due to cerebrovascular accident, Parkinson's disease, multiple sclerosis, spinal cord injury, and peripheral neuropathy.
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PMID:Evaluation and management of the urologic consequences of neurologic disease. 908 42


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