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Abstract
James Parkinson accurately described the motor problems of Parkinson’s disease but also noted several non-motoric features. The traditional motor symptoms are not necessarily the features that lead to the most profound disability , several studies have shown that the non-motoric symptoms of Parkinson’s disease, such as depression, psychosis ,falls and sleep disturbance, have greater significance when assessed by quality of life measures,institutionalization rates or health economics.
There is a range of non-motor symptoms in Parkinson’s disease: Autonomic symptoms in the heart and vascular system, gut and bladder. Psychiatric symptoms: dementia, depression, hallucinations. Sleep Disorders .Other non-motor symptoms, such as, olfactory impairment and pain.
As regard autonomic dysfunction, the following areas in the central nervous system and in the peripheral nervous system show neuropathological changes typical for Parkinson’s disease: Central: diencephalon, pituitary gland, hypothalamus, locus ceruleus, formatio reticularis, raphe nucleus, Edinger-Westphal nucleus, nucleus ambiguous, nucleus basalis of Meynert, dorsal vagal nucleus.Peripheral: sympathetic ganglia, adrenal gland, parasympathetic ganglia (pre- and postganglionic), gastrointestinal, urogenital, cardiovascular plexus, columna intermediolateralia.