[Autonomic disorders in idiopathic Parkinson syndrome: diagnostic relevance and therapeutic possibilities].

Involvement of the autonomic nervous system in Parkinson's disease (PD) demonstrates the multiple system character of this disease exceeding the extrapyramidal system. Forty to sixty percent of patients with PD suffer from symptoms of autonomic failure impairing their quality of life. Autonomic failure in PD is caused by damage to the postganglionic part of the autonomic nervous system. Scintigraphy with radiolabeled metaiodobenzylguanidin (MIBG) provides evidence of autonomic involvement at an early stage of the disease and enables an early differential diagnosis of PD versus other neurodegenerative disorders. Sensitivity to identify PD versus multiple system atrophy is 89.7%, specificity in 94.6%. Orthostatic hypotension is a frequently overlooked symptom in PD. Diagnosis and cause of orthostatic hypotension can be identified with clinical methods. There are effective physical and pharmacological treatments to improve symptoms.