[Nosological correlation between autonomic failure with Lewy bodies and Parkinson's disease--comparative assessment of clinical features in both diseases].
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)
Tamura
N
N
Department of Neurology, Saitama Medical School.
Shimazu
K
K
Yamamoto
T
T
Watanabe
S
S
Hamaguchi
K
K
D000368:Aged; D000369:Aged, 80 and over; D001342:Autonomic Nervous System Diseases / Q000145:classification / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D008875:Middle Aged; D009474:Neurons / Q000473:pathology; D010300:Parkinson Disease / Q000145:classification / Q000473:pathology*; D014617:Vacuoles / Q000473:pathology