Non-motor symptoms of Parkinson's disease: diagnosis and management.
BACKGROUND
Non-motor symptoms (NMS) of Parkinson's disease (PD) are a key determinant of health, quality of life (QoL) and societal cost of PD. They are often less appreciated than motor symptoms but are important sources of disability for many PD patients.


METHODS
Literature search was performed using the reference databases Medline, Science Citation Index and EMBASE. The keywords used were 'non-motor symptoms', Parkinson's disease, olfaction and constipation. Papers discovered by this search were reviewed, as were references cited therein.


RESULTS
Contrary to common perception, many NMS of PD occur early in PD and some may even predate the diagnosis of PD that is based on motor signs. These include olfactory deficit, sleep problems such as rapid eye movement behaviour disorder, constipation and the more recently described male erectile dysfunction.


CONCLUSIONS
There is compelling evidence that non-motor symptoms of PD play a dominant role in the QoL and disability of PD patients and the QoL of their 'informal' carers. Effective clinical management of PD therefore demands that these symptoms be identified and to the extent possible treated.
Salawu
F K
FK
Neurology Unit, Department of Medicine, Federal Medical Centre Yola, Nigeria. dr_abdulsalawu@yahoo.com
Danburam
A
A
Olokoba
A B
AB
D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003248:Constipation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D015259:Dopamine Agents / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006304:Health Status; D006801:Humans; D008297:Male; D000857:Olfaction Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
D015259:Dopamine Agents