Review ArticleAutonomic dysfunction in movement disordersChaudhuri, K. RayAuthor Information Regional Movement Disorders and Autonomic Unit, Department of Neurology, King's College Hospital, and University Hospital Lewisham, Guy's, King's and St Thomas' School of Medicine, London, UK Correspondence to Dr K. Ray Chaudhuri, Co-Director, Regional Movement Disorders and Autonomic Unit, Department of Neurology, Mapother House, King's College Hospital, Denmark Hill, London SE5 9RS, UK. Tel: +44 020 7346 5319; fax: +44 020 7346 5332; e-mail: email@example.com Current Opinion in Neurology: August 2001 - Volume 14 - Issue 4 - p 505-511 Buy Abstract Dysfunction of the autonomic nervous system is an under-recognised but important aspect of the aetiological and clinical manifestation of primary degenerative dysautonomias such as multiple system atrophy (MSA) and Parkinson's disease (PD). Although the clinical presentation of dysautonomia in these two disorders may overlap, yet pathological and in vivo imaging studies suggest considerable differences. Functional imaging studies suggest that selective cardiac sympathetic denervation may occur early in PD but not in other parkinsonian syndromes. The clinical implication of this apparently disease specific peripheral dysautonomia is unknown and would be the subject of much interest in future years. Dysautonomia in degenerative disorders also affect respiration, genitourinary function and sleep. Sleep related disorders such as rapid eye movement behaviour disorder and urinary voiding dysfunction appear to precede the development of PD related symptoms while patients with sporadic ataxia have been shown to progress to develop MSA. Dysautonomia has also been recognised in other movement disorders, examples being the combination of dystonia and complex regional pain syndrome with elevated HLA-DR13 and late onset Huntington's disease presenting with dominant parkinsonism and minimal chorea. These studies have helped progress in various diagnostic and management parameters in relation to autonomic dysfunction and movement disorders. © 2001 Lippincott Williams & Wilkins, Inc.