title: Parkinson's disease with Onuf's nucleus involvement mimicking multiple system atrophy.
abstract: Urinary frequency, urgency and nocturia are common complaints in Parkinson's disease (PD). The hypothesis most widely proposed to explain neurogenic bladder symptoms in PD is that cell loss in the substantia nigra may cause detrusor hyperactivity due to a loss in the D1 receptor-mediated tonic inhibition of the micturition reflex, although other causes including anti-parkinsonian medication cortical effects have been considered.1 We present the clinical and pathological findings of a patient with parkinsonism who presented with prominent dysautonomia and a poor response to dopaminergic medications and was considered to have possible multiple system atrophy parkinsonism (MSA-P). Pathological examination revealed that the patient had PD with α-synuclein pathology in the Onuf's nucleus (ON).
authors.affiliation: Queen Square Brain Bank, Department of Molecular Neuroscience, Institute of Neurology, University College London, London, WC1N 1PJ, UK.
authors.forename: Sean Stephen
authors.initials: SS
authors.lastname: O'Sullivan
authors.forename: Luke A
authors.initials: LA
authors.lastname: Massey
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.forename: Tamas
authors.initials: T
authors.lastname: Revesz
authors.forename: Andrew
authors.initials: A
authors.lastname: Lees
authors.forename: Janice
authors.initials: J
authors.lastname: Holton