Anosmia in patients with Parkinson syndrome
D.Kountouris – Center for Neurological Diagnosis, Athens, Greece.
Introduction: Parkinson syndrome is mainly characterized by tremor, akinesia, muscular rigidity and autonomic system dysfunction. In addition to those symptoms, there are several times emotional incontinence, bradyphrenia of dementia, dysfunction of sarcades etc.
Anosmia, as secondary feature for parkinson syndrome has not has not been yet observed or described.
Aim of this study is to explore the symptom of anosmia in relation to Parkinson syndrome as well as any other relation concerning the follow-up and prognosis of the disease.
Methods and results: In period of six years time, 328 patients (122female and 206 male) with Parkinson, syndrome were examined. In addition to all possible neurological examination, EEG and cranial CT examinations were also performed in all patients.
Evoked potential were performed in 60% of the patients. Patients whose smell function was extraordinarily sensitive were not included.A typical bilateral anosmia was detected in 11 patients while only one of them actually complain about it. The rest 10 patients had not even noticed it. All 11 patients were attacked by the typical symptoms of the disease within short time of 8 years.
All symptoms, in particular those of akinesia and rigidity, had been quite distinct. The patients response to treatment with L-Dopa was moderate and the progress of the disease was rather bad. In 5 of the patients, CT recordings revealed light pathological results. On the contrary, Brain Auditory Evoked Potentials (BAEPs), Visual Evoked Potential (VEPs) or somatosensory Evoked Potential (SEPs) were abnormal in 10 of them.
Six times, the Electroencephalography (EEG) recordings showed bilateral frontal d-focus with no corresponding CT findings (tumor or infraction etc).
Conclusion:
1. In general we found that anosmia can be considered as accompanying symptom in Parkinson patients to an extent of 3,4%.
2. Heave clinical findings accompaying the disease lead to the result that additional exisitng anosmia is a sign of bad prognosis.
Abstract published in abstract book of the 5th International Congress of Parkinson `s Disease and Movement Disorders.
Paper presented at the 5th International Congress of Parkinson`s Disease and Movement Disorders, New York, U.S.A. October 10-14, 1998