ORTHOSTATIC HYPOTENSION IN IDIOPATHIC PARKINSONS DISEASE

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